A System for Early Diagnosis, Systematic Management, Timely Treatment of High-Risk Groups, and Prevention of Mortality Must Be Established
The Korean Academy of Tuberculosis and Respiratory Diseases has raised the argument that, ahead of the presidential election, a system for the 'early diagnosis, systematic management, timely treatment of high-risk groups, and prevention of mortality' for severe respiratory diseases must be established in the context of a super-aged society.
Korean Academy of Tuberculosis and Respiratory Diseases
On April 18, the Korean Academy of Tuberculosis and Respiratory Diseases announced that it had delivered a policy proposal to each political party, outlining measures to improve the treatment environment for severe respiratory diseases, which are prevalent among elderly patients. The proposal centers on four major improvement measures: the introduction of pulmonary function tests in national health examinations, implementation of a primary care chronic disease management project for asthma and chronic obstructive pulmonary disease (COPD), inclusion of new COPD drugs in the national health insurance program, and the introduction of high-dose influenza vaccines into the National Immunization Program (NIP).
Last year, South Korea entered a super-aged society, with the proportion of people aged 65 and older exceeding approximately 20% of the total population. The country is also cited as having the highest concentration of ultrafine dust among OECD member states. In particular, COPD is the third leading cause of death among severe respiratory diseases globally, and the World Health Organization (WHO) has designated it as one of the five major non-communicable diseases requiring global management. The prevalence of COPD among Koreans aged 65 and older is 25.6%, and the number of COPD patients is expected to surge due to population aging and other factors. The academy estimates that the socioeconomic burden of COPD, including medical and nursing care costs, amounts to 1.4 trillion won.
First, the academy recommended that pulmonary function tests be introduced into the national health examination in order to detect and diagnose COPD early. COPD does not present symptoms until more than 50% of lung function is lost. Once the lungs are damaged, they cannot recover. However, the awareness rate of COPD is only 2.3%, which is significantly lower than that of hypertension (71.2%) and diabetes (66.6%), even though their prevalence rates are similar.
Accordingly, the academy stated that pulmonary function tests should be conducted during national health examinations for high-risk groups, such as individuals aged 50 and 60 who have smoked for at least 10 years. In this case, the annual financial cost is expected to be about 2.3 billion won. The academy emphasized that early detection and timely treatment of COPD through pulmonary function tests would significantly reduce the enormous socioeconomic costs, making it a cost-effective measure.
The academy also urged the establishment of an early diagnosis and continuous management system for respiratory diseases through the implementation of a pilot project for primary care chronic disease management of asthma and COPD. Not only is the prescription rate of inhalers (inhaled steroids and inhaled bronchodilators), which are mainly used by asthma and COPD patients, low in primary care institutions, but 70-80% of asthma patients are unable to use inhalers correctly. If patients do not properly learn how to use inhalers, symptom control becomes difficult, and the risk of acute exacerbations and side effects increases.
In addition, the academy recommended that new biological drugs for COPD be quickly included in the national health insurance program in order to ensure timely treatment of severe respiratory diseases. This would help prevent hospitalizations and deaths due to acute exacerbations and reduce the socioeconomic burden, including medical expenses.
The academy also suggested that high-dose influenza vaccines for the elderly be included in the national essential immunization program. High-dose influenza vaccines contain four times the amount of antigen compared to standard-dose vaccines and can dramatically reduce the risk of hospitalization and death among the elderly. For this reason, 18 countries, including the United States, Canada, and major European nations, are already using high-dose influenza vaccines, and 14 of these countries have incorporated them into their national immunization programs.
Lee Eunju, spokesperson for the Korean Academy of Tuberculosis and Respiratory Diseases, stated, "Since South Korea became a super-aged society in December last year, the number of elderly patients with COPD and asthma is bound to surge," adding, "It is time to improve the overall treatment environment for severe respiratory diseases, from diagnosis to treatment and management."
Yoo Kwangha, president of the Korean Academy of Tuberculosis and Respiratory Diseases, also said, "If COPD and asthma are not diagnosed early and managed continuously with timely treatment, the daily lives and survival of the elderly will be seriously threatened, and the resulting socioeconomic burden will increase." He urged, "The new government should actively guarantee the 'right to breathe' (respiratory rights) for the elderly, which has been overlooked for too long, in order to promote the health of the elderly and reduce socioeconomic costs."
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