Healthcare and Societal Costs in Patients with COPD and Breathlessness after Completion of a Comprehensive Rehabilitation Program

C.A. Verberkt, M.H.J. van den Beuken-van Everdingen, C.D. Dirksen, J.M.G.A. Schols, L.E.G.W. Vanfleteren, F.M.E. Franssen, M.T.J. Groenen, E.F.M. Wouters, D.J.A. Janssen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Breathlessness is one of the most frequent symptoms in chronic obstructive pulmonary disease (COPD). COPD may result in disability, decreased productivity and increased healthcare costs. The presence of comorbidities increases healthcare utilization. However, the impact of breathlessness burden on healthcare utilization and daily activities is unclear. This study's goal was to analyze the impact of breathlessness burden on healthcare and societal costs. In this observational single-center study, patients with COPD were followed-up for 24 months after completion of a comprehensive pulmonary rehabilitation program. Every three months participants completed a cost questionnaire, covering healthcare utilization and impact on daily activities. The results were compared between participants with low (modified Medical Research Council (mMRC) grade <2; LBB) and high baseline breathlessness burden (mMRC grade >= 2; HBB). Healthcare costs in year 1 were euro7302 (95% confidence interval euro6476-euro8258) for participants with LBB and euro10,738 (euro9141-euro12,708) for participants with HBB. In year 2, costs were euro8830 (euro7372-euro10,562) and euro14,933 (euro12,041-euro18,520), respectively. Main cost drivers were hospitalizations, contact with other healthcare professionals and rehabilitation. Costs outside the healthcare sector in year 1 were euro682 (euro520-euro900) for participants with LBB and euro1520 (euro1210-euro1947) for participants with HBB. In year 2, costs were euro829 (euro662-euro1046) and euro1457 (euro1126-euro1821) respectively. HBB in patients with COPD is associated with higher healthcare and societal costs, which increases over time. This study highlights the relevance of reducing costs with adequate breathlessness relief. When conventional approaches fail to improve breathlessness, a personalized holistic approach is warranted.
Original languageEnglish
Pages (from-to)170-180
Number of pages11
JournalCopd-Journal of Chronic Obstructive Pulmonary Disease
Issue number2
Publication statusPublished - 4 Mar 2021


  • COPD
  • breathlessness
  • healthcare utilization
  • societal costs

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