Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease (COLD), is a condition characterised by difficulty in breathing, shortness of breath, wheezing, chest tightness, and other respiratory symptoms that progress over time. The disease is often caused by smoking; however, long-term exposure to other factors such as pollution, chemical fumes, and dust can also lead to the development of COPD. In the US, GlobalData estimates that approximately 14 million people ages 35 years and older were diagnosed with COPD in 2017, and the Centers for Diseases Control and Prevention (CDC) estimated that approximately 16 million people of ages 18 years and older had been diagnosed with COPD, emphysema, or chronic bronchitis in their lifetime. However, COPD frequently goes undiagnosed and leads to many years of poor health.

COPD is a term that includes several diseases with similar symptoms, but varying causes and effects. COPD includes chronic bronchitis, chronic respiratory failure, refractory asthma, bronchiectasis, and emphysema. COPD is a long-term illness with debilitating effects and is not completely reversible, even with treatment. COPD is also a significant cause of mortality: the World Health Organization (WHO) estimates that COPD accounted for approximately 5% of all deaths globally in 2015. According to GlobalData’s epidemiology forecast, fewer than 50% of cases ages 35 years and older are diagnosed in the eight major markets (8MM; US, France, Germany, Italy, Spain, the UK, Japan, and Australia) (Figure 1). Undiagnosed COPD contributes to a significant proportion of the economic and healthcare burden of the disease in the population because of how frequently patients experience adverse conditions related to the disease, such as a co-occurring illnesses, increased risk of death, reduced quality of life, and income lost to disability and reduced healthy life expectancy.

Figure 1: 8MM, proportion of undiagnosed prevalent cases of COPD, both sexes, ages ≥35 years, 2015, %

Source: GlobalData                                                                                     © GlobalData

5EU = France, Germany, Italy, Spain, and UK; 8MM = US, 5EU, Japan, and Australia

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Reducing the risk factors as COPD grows

The number of cases of diagnosed and undiagnosed COPD are expected to increase in the 8MM due to population growth and aging. This means that governments and public health agencies will need to prioritise strategies that focus on reducing the risk factors for COPD such as smoking and exposure to chemical fumes, and dust from the environment and workplace, as well as on increasing disease awareness to promote early and increased diagnosis and continuing to research and implement public health interventions to improve the prognosis of people diagnosed. Plans with a clear approach and set goals are important because COPD is more prevalent in people ages 40 years and older; patients who tend to suffer from significant co-occurring illnesses. More than half of all COPD patients suffer from cardiovascular diseases (CVDs), and also to varying degrees from diabetes, asthma, osteoporosis, cataracts, and glaucoma, making disease management more complicated and stressing the importance of increasing the diagnosis rate of COPD across the 8MM.

In May 2017 the CDC announced a COPD National Action Plan centered on empowering people with COPD to recognise the symptoms early, enabling health care professionals to establish a standardised diagnosis criteria, improve access to healthcare, promoting research and analysis of COPD data, and using that data to inform public health officials. Implementing similar programs in the other major markets will be imperative to reduce the burden of undiagnosed COPD. Regular medical follow-ups in older adults and individuals with respiratory conditions and CVDs will be equally important in achieving early COPD diagnosis and improving outcomes for older patients.

Further detail on the epidemiology forecast for COPD in the 8MM can be found in GlobalData’s EpiCast Report: Chronic Obstructive Pulmonary Disease – Epidemiology Forecast to 2025 and on GlobalData’s EpiCast Model:  Chronic Obstructive Pulmonary Disease – Epidemiology Forecast to 2025.