Social Burden of Copd

OBJECTIVES: To evaluate the social and economic burden of COPD in Bulgaria generated from the disability adjusted life years (DALY). METHODS: An observational study among 426 Bulgarian COPD patients was conducted for the period 2014-2015. DALYs were estimated per the World Health Organization methodology. In our sample no patients died during the duration of the study, this is why a value of 0 was assumed for years of life lost (YLL). Disability weight (DW) for COPD value was obtained from the study of Haagsma et al. The average life expectancy was assumed to be 88 years, as per WHO methodology. Monetarized value was obtained through the multiplication of DALY by the GDP/capita. RESULTS: The DALYs in the group of patients with mild severity are lowest due to the low disutility index and number of patients in this sample group (n=30). On average a patient with mild COPD spends 0.62 years of his life in disability due to the disease, while those with moderate and severe spend 6.00 and 9.00 years respectively. Assuming annual working income is lost by patients for the DALY period, costs of lost productivity is obtained by multiplying the average DALYs by the GDP per capita, thus expressing the resources "lost" per patient throughout his life. This amounted to the following indirect costs experienced by patients: 3,596.526; 34,204.016; 51,332.206 respectively. CONCLUSIONS: This is the first Bulgarian study evaluating the economic and social burden of COPD and first one that applies the DALYs for COPD in Bulgaria. To the best of our knowledge, it is also the first one that monetizes the values for DALYs. We demonstrated a significant societal burden of COPD in Bulgaria, which is in correlation with severity of the disease.