Zafar Zafari, M.D., Ph.D

Zafar Zafari, M.D., Ph.D

University of Maryland at Baltimore

Which Interventions for COPD are Most Cost-Effective?

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. The chronic condition is associated with a substantial health and economic burden on society. To reduce the burden of COPD, researchers have attempted to design new medical and policy interventions. However, these interventions come at a cost, and it is not known whether they produce value for the resources they consume. We will develop a national simulation model of COPD to quantify the natural history of disease progression, as well as lifetime health and costs of COPD patients in the U.S. We will measure and compare health and economic benefits of a variety of different medical (including medications and pulmonary rehabilitation) and policy (including smoking cessation policies) interventions to see which of them would produce the highest value for society.


We quantified the health-related quality of life, and its variability, among COPD patients. We had a paper published in the Journal Expert Review of Respiratory Medicine, 2020. We have also built a national population-level policy model of COPD. As the first step towards our policy model, we projected the 20-year health and economic burden of COPD in the U.S. We quantified both the direct and indirect costs (i.e., productivity losses) and measured health in terms of the quality-adjusted life years, number of minor and severe exacerbations requiring hospitalizations, and number of deaths. A paper based on this research, projecting the 20-year health and economic burden of COPD in the U.S., was accepted for publication in CHEST. The study projected that the 20-year direct costs of COPD are expected to be $948.95 billion ($669.69 billion-$1281.37 billion), from 2019-3038, in the U.S. In addition, the 20-year indirect absenteeism costs and losses of quality-adjusted life year (QALYs) associated with COPD are expected to be $132.30 billion ($92.49 billion-$179.45 billion), and $53.73 million (10.22 million-132.67 million), respectively, over the same time span.

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