The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020-50: a health-augmented macroeconomic modelling study

Background Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and imposes a substantial economic burden. Gaining a thorough understanding of the economic implications of COPD is an important prerequisite for sound, evidence-based policy making. We aimed to estimate the macroeconomic burden of COPD for each country and establish its distribution across world regions.Methods In this health-augmented macroeconomic modelling study we estimated the macroeconomic burden of COPD for 204 countries and territories over the period 2020-50. The model accounted for (1) the effect of COPD mortality and morbidity on labour supply, (2) age and sex specific differences in education and work experience among those affected by COPD, and (3) the impact of COPD treatment costs on physical capital accumulation. We obtained data from various public sources including the Global Burden of Disease Study 2019, the World Bank database, and the literature. The macroeconomic burden of COPD was assessed by comparing gross domestic product (GDP) between a scenario projecting disease prevalence based on current estimates and a counterfactual scenario with zero COPD prevalence from 2020 to 2050.Findings Our findings suggest that COPD will cost the world economy INT$4<middle dot>326 trillion (uncertainty interval 3<middle dot>327-5<middle dot>516; at constant 2017 prices) in 2020-50. This economic effect is equivalent to a yearly tax of 0<middle dot>111% (0<middle dot>085-0<middle dot>141) on global GDP. China and the USA face the largest economic burdens from COPD, accounting for INT$1<middle dot>363 trillion (uncertainty interval 1<middle dot>034-1<middle dot>801) and INT$1<middle dot>037 trillion (0<middle dot>868-1<middle dot>175), respectively.Interpretation The macroeconomic burden of COPD is large and unequally distributed across countries, world regions, and income levels. Our study stresses the urgent need to invest in global efforts to curb the health and economic burdens of COPD. Investments in effective interventions against COPD do not represent a burden but could instead provide substantial economic returns in the foreseeable future.