What is the Economic Burden of Asthma?

A study assessed economic outcomes associated with controlled versus uncontrolled persistent asthma in patients who were receiving treatment and were considered adherent. Lulu K. Lee, PhD, of the Health Outcomes Practice at Kantar Health in San Mateo, California, and colleagues found that uncontrolled asthma is associated with higher work impairment, healthcare resource utilization, and costs. The results were presented at the 2018 AAAAI Annual Meeting.

The researchers identified 242 patients with controlled asthma and 564 patients with uncontrolled asthma from the 2015 and 2016 U.S. National Health and Wellness Survey. Adherence was assessed with the Morisky Medication Adherence Scale, and patients with medium/high adherence were considered “adherent.” The researchers also used the Asthma Control Test, with scores of ≤19 signifying uncontrolled disease and scores ranging from 20 to 25 signifying controlled disease. They assessed the following economic outcomes:

  • Work Productivity and Activity Impairment-General Health Scale
  • Health resource utilization
  • Annual indirect and direct costs

The mean patient age was 49 years, and more than half (66.7%) were female.

Patients with uncontrolled disease experienced 1.4 times greater work productivity loss compared with those with controlled disease (adjusted mean=34.96% vs 25.21%; P=.036). The loss in productivity led to those with uncontrolled disease to experience 1.5 times higher annual indirect costs compared with those with controlled disease (adjusted mean=$11,537 vs $7,630; P=.016).

Uncontrolled disease was also associated with twice as many annual hospitalizations (adjusted mean = 0.26 vs 0.12; P<.036) and significantly more medical visits, including:

  • Emergency department: adjusted mean=0.53 vs 0.31 (P=.003)
  • Healthcare provider: adjusted mean=7.83 vs 6.14 (P=.011)

This led to 1.5 times higher annual direct costs for those with uncontrolled disease (adjusted mean=$31,793 vs $21,240; P<.001).

“Significant unmet need in asthma management, independent of adherence or asthma severity, was demonstrated [in the study],” the authors concluded, noting that a better understanding of treatment needs could improve control and reduce the economic burden.