Asthma severity and medical resource utilisation

Abstract

Asthma represents a growing public health problem and the cost of asthma has been rising in many countries. The aim of this study was to estimate the direct and indirect cost of asthma among adult patients in Italy, and to assess the relationship between healthcare resource use and asthma severity according to the Global Initiative for Asthma (GINA) classification system.A multicentre cross-sectional study was conducted in 16 Italian hospital-based specialised asthma clinics. Data collection was based on self-administered questionnaires and took place during the period May 1-November 30, 1999, and 500 consecutive patients with asthma, aged 18-55 yrs, were enrolled during regularly scheduled visits. Direct costs (drugs, physician visits, emergency service use and hospitalisation), indirect costs (loss of paid workdays) and total costs were determined in euros (J) for 1999.Patients with more severe disease, as classified by the GINA guideline, exhibited more night-time and daytime symptoms and were more limited in performing normal daily activities. The mean total cost of asthma per patient per year was estimated to be J1,260; drug costs accounted for 16%, physician costs 12%, emergency service and hospitalisation costs 20% and indirect costs 52% of the mean cost. Stratified by severity, the total annual cost per patient amounted to J720, J1,046, J1,535 and J3,328 for patients with intermittent, mild persistent, moderate persistent and severe persistent asthma, respectively.Asthma severity, as determined by the Global Initiative for Asthma classification, is significantly associated with symptoms, limitations in normal daily activities, asthmarelated medical resource utilisation and both direct and indirect costs. Asthma control is not only a clinical but also an economic imperative.

Efficacy and safety of etanercept in moderate-to-severe asthma: a randomised, controlled trial

“…The first line of therapy for asthma includes leukotriene modifiers and inhaled corticosteroids used alone or in combination with long-acting b 2 -adrenoceptor agonists (LABAs); however, ,5-15% of subjects with severe disease either do not respond or respond incompletely to this therapy [5][6][7]. For subjects with severe asthma, treatment with drugs that modify the immune response, or therapies with monoclonal antibodies directed to immunoglobulin (Ig)E or interleukin-5 are effective, although efficacy appears to be restricted to specific patient subtypes [8,9].…”

TENOR risk score predicts healthcare in adults with severe or difficult-to-treat asthma

“…The high economic costs of adult asthma include direct medical costs, such as emergency department (ED) visits and hospital admissions, as well as indirect costs associated with loss of productivity [1][2][3]. Moreover, higher asthma costs have been consistently associated with increasing asthma severity [4][5][6]. In 2004, acute hospital care (ED and inpatient care) accounted for 31% of the $11.5 billion in direct costs associated with asthma in the USA [7].…”

Pilot Project «All-Russian Registry of Patients with Severe Bronchial Asthma.» The First Results in a Children’s Group of Patients (Moscow’s Observation Program)

“…Особенно острым является вопрос, связанный с терапией паци-ентов с тяжелой БА. И хотя данная группа составляет около 5% всех больных БА, на нее приходится более половины всех затрат на болезнь [9]; кроме того, по некоторым данным, расходы на пациентов с тяжелой астмой могут составлять 80% и более от общих расходов здравоохранения на БА [9,10]. Эти пациенты полу-чают преимущественно комбинированную терапию -высокие дозы ингаляционных глюкокортикостероидов и длительно действующие β2-агонисты (ДДБА), а также антагонисты лейкотриеновых рецепторов (монтелукаст), М-холинолитики (тиотропия бромид), пролонгирован-ные ксантины (теофиллин длительного действия) и ген-но-инженерные биологические препараты (монокло-нальные антитела: например, к IgE или IL5).…”