Burden of Asthma in Elderly Japanese Patients: Using Hospital-Based Administrative Claims Data

Abstract

Introduction: Data are lacking on severe asthma burden in elderly people in Japan. We assessed the prevalence and clinical/economic burden of severe asthma and asthma-related hospitalizations in elderly and younger Japanese patients. Methods: This retrospective study analyzed outpatient claims data and inpatient hospital discharge records among patients aged C 15 years with asthma (defined as C 2 prescriptions of inhaled corticosteroids [ICS] or ICS/long-acting beta-agonists [LABA]) between 1 July 2014 and 30 June 2017. We analyzed the outpatient visit assessment population with severe asthma (C 240-day prescription of highdose ICS and C 90-day prescription of C 1 additional controllers) and the asthma-related hospitalization population (C 1 hospital Digital Features To view digital features for this article go to

The burden of systemic corticosteroid use in asthma management in Asia

“…Data on SCS use in Japan were obtained from two claims analyses previously described. In the larger study ( n = 35,742), 31.1% of patients with severe asthma used SCS as daily maintenance therapy, with a mean cumulative exposure of 847 mg/year 44 . Data from the KEIFU study revealed that, over a 12‐month period, SCS were prescribed to 67.4% of patients with SUA, 45.9% with SCA and 16.2% with mild‐to‐moderate asthma at mean daily cumulative exposures of 3.3 mg (1.2 mg via injection), 1.6 and 0.2 mg, respectively.…”

“…43 An analysis of hospital-based administrative claims for 35,742 outpatients from July 2014 to June 2017 in Japan revealed that 11.8% of patients with asthma had severe disease, comprising 8.2% of patients aged 15-39 years, 12.8% of those aged 40-64 years, and 12.4% of those aged ≥65 years. 44 Also in Japan, a health insurance claims analysis for 10,579 patients from 2014 to 2015 (KEIFU study) revealed that 7.8% had severe asthma, 2.5% had severe uncontrolled asthma (SUA) and 5.3% had severe controlled asthma (SCA). 45 In South Korea, a national, population-based study that evaluated data by year from 2002 (n = 597,344) to 2015 (n = 1,130,530) reported an increase in overall asthma prevalence from 1.6% to 2.2% and in severe asthma from 3.5% to 6.1% over that time.…”

“…In the larger study (n = 35,742), 31.1% of patients with severe asthma used SCS as daily maintenance therapy, with a mean cumulative exposure of 847 mg/year. 44 Data from the KEIFU study revealed that, over a 12-month period, SCS were prescribed to 67.4% of patients with SUA, 45.9% with SCA and 16.2% with mild-to-moderate asthma at mean daily cumulative exposures of 3.3 mg (1.2 mg via injection), 1.6 and 0.2 mg, respectively. Proportions of patients who had been prescribed SCS burst regimens were 53.9% with SUA (2.3 short courses/year), 14.9% with SCA (0.3 courses/year) and 13.2% with mild-to-moderate asthma (0.4 courses/year).…”

“…An analysis of hospital‐based administrative claims for 35,742 outpatients from July 2014 to June 2017 in Japan revealed that 11.8% of patients with asthma had severe disease, comprising 8.2% of patients aged 15–39 years, 12.8% of those aged 40–64 years, and 12.4% of those aged ≥65 years 44 . Also in Japan, a health insurance claims analysis for 10,579 patients from 2014 to 2015 (KEIFU study) revealed that 7.8% had severe asthma, 2.5% had severe uncontrolled asthma (SUA) and 5.3% had severe controlled asthma (SCA) 45 …”

Management of Elderly Asthma: Key Questions and Tentative Answers

“… 3 An understanding of EA is critical; it imposes considerable burdens in terms of mortality and morbidity, and expenditure. 4 5 6 7 However, clinicians lack knowledge of EA and thus often prescribe inappropriate management. In this review, we ask 3 key questions frequently encountered during EA diagnosis and treatment.…”