Outpatient-Based Pulmonary Rehabilitation for COPD : A Cost of Illness Study

Pulmonary rehabilitation (PR) as recommended by COPD guidelines is a multimodality educational, self-management, supervised exercise program, resulting in improved symptom control, quality of life, and reduction of exacerbations, but there is a need to establish the affordability of PR for healthcare providers. We designed a cost-of-illness study of PR in advanced COPD, with an 8-week hospital-based program, measuring direct healthcare costs for 12 months before and after PR. In 31 patients (female = 16), aged 68 (±8) years, and FEV1% predicted to be 40 (±16.6), there was a reduction in inpatient hospital stay by net 2.35 days (78%; P=0.027) and routine primary care visits. Costs were reduced by £1835 per person (base year 2008), with a saving of £791 to 1313 GBP per person, per year. Therefore, PR provision in COPD is likely to be affordable due to reduced direct healthcare costs, even without considering the individual and societal benefits.