US Pharm. 2014;39(7):7.

Data from 2010 on chronic obstructive pulmonary disease (COPD) and asthma in Medicare beneficiaries were analyzed by the Centers for Medicare and Medicaid Services.

Medicare Spending: Per capita spending on COPD and asthma was $46,764. Spending was 8% higher for males. Although the 2% difference in overall per capita spending for both conditions (asthma, $37,831; COPD, $37,028) was not significant, the amount expended on males was 5.4% more for asthma ($41,157) than for COPD ($39,070). Less money was expended on females for both conditions, but the per capita expense for asthma ($36,454) was 2.3% more than that for COPD ($35,648). Spending on COPD for patients aged <65 years ($47,944) was 5% more than that for asthma ($45,654), but the gap narrowed to 1.8% (COPD, $36,341; asthma, $36,981) in patients aged >65 years. In the case of asthma and COPD comorbidity, 26% more was spent on patients aged <65 years ($57,782) versus those aged >65 years ($45,669).

Prevalence Among Beneficiaries: As comorbid conditions, asthma and COPD had an overall prevalence of 0.6%. COPD prevalence (3%) among Medicare recipients was about four times that for asthma (0.8%). Among dual Medicare-Medicaid beneficiaries and their Medicare-only counterparts, there were 29% and 19% fewer asthma cases, respectively, in patients aged ≥65 years than in those aged <65 years; in contrast, COPD prevalence increased by 53% and 20%, respectively. Among females aged ≥65 years, prevalence of COPD (10.9%) was more than double that for asthma (4.9%), but among males, COPD prevalence was 11.8% versus 3% for asthma—a threefold increase. COPD and asthma prevalence rose considerably with age progression (3.3% and 0.9%, respectively, for age ≥65 years).

Age Progression: The difference in COPD prevalence among males and females aged 65–74 years was 11%, and the difference widened with age progression—namely, a difference of 23% and 40% for beneficiaries aged 75–84 years and those aged ≥85 years, respectively. Between ages 75–84 years and ≥85 years, COPD prevalence increased 5.3% in males and decreased 7.5% in females. Among females aged >65 years, asthma prevalence decreased with age progression—namely 9%, 7.7%, and 5.5% among those aged 65–74, 75–84, and 85 years, respectively. Asthma prevalence among males aged ≥65 years remained relatively steady (4.9%) across age groups. The prevalence trend for asthma was the reverse of that for COPD; namely, with age progression, the divergence between males and females decreased by 14.7% between ages 65–74 years and 75–84 years, and decreased by 28.7% between age 75–84 years and ≥85 years.

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