Clinical and economic burden of severe asthma: A French cohort study

Abstract

To describe the clinical and economic burden of severe asthma in France over 12 months. Methods: Data were retrieved from the observational, prospective "Cohorte Obstruction Bronchique et Asthme" (COBRA) cohort, which has enrolled nearly 1000 asthma patients since 2007 from throughout France. Patients undergoing treatment with GINA step-4 or 5 medications uninterruptedly for 12 months (thus defining "severe asthma") were identified and their clinical data used to describe the clinical burden of asthma (exacerbations, symptoms outside exacerbations, and level of asthma control). Patients' utilization of healthcare resources was described and used to estimate the direct medical costs incurred to treat severe asthma. Results: 155 patients were included in the present study. Over the 12-month period of interest, 128 (83%) patients experienced at least one asthma exacerbation, 22 (14%) patients were hospitalized for asthma, 133 (86%) patients experienced continuous symptoms outside exacerbations, and 77 (50%) patients experienced important limitations in daily life activities. The median number of asthma-related drugs used was 4. The mean estimated annual asthma-related cost was 8,222 euros (standard deviation, SD = 11,886), including 7,229 euros (SD = 11,703) for controller medications. Conclusion: Symptoms outside exacerbation periods are highly prevalent in severe asthma patients, for whom the main driver of medical costs is controller medication.

Prevalence and characterization of severe asthma in Hungary

“…This determination essentially covers asthma patients treated according to the fourth and fifth step of GINA asthma treatment guidelines 23,24 . The reported percentage of severe asthma in the total asthma population was 0.89%, which is lower than the prevalence reported in most other studies [12][13][14][15][16] . However, there is a considerable 20 .…”

“…Depending on the study definition, and owing to the differences in the environment, health care system and expertise of the treatment team the range of published prevalence data is between 2.5% and 20% with an estimated average value about 5-10% of all asthmatics [12][13][14][15][16][17] . We have not had accurate data about the Hungarian…”

“…www.nature.com/scientificreports www.nature.com/scientificreports/ variation in the prevalence estimates of severe asthma in different countries ranging from 2.5% to 8.1%, even some studies reported as high as 20%, indicating partly population heterogeneity, different environments and health care system, but also support the notion that current guidelines may be ambiguous[12][13][14][15][16][17] .…”

Development and initial validation of the Asthma Severity Scoring System (ASSESS)

“…[25][26][27][28] Asthma severity determination is also discordant between physicians in both primary care 29 and specialist 30 settings. Objective measures, such as ASSESS, have potential to mitigate the increasing costs of asthma severity in both the United States 31,32 and elsewhere 33,34 through comprehensive assessment of treatment responses and, ultimately, elimination of unnecessary treatment in patients who do not benefit. ASSESS was developed in response to the unmet need for a severity scoring system in adolescent and adult patients with asthma.…”

Efficacy and safety of treatment with dupilumab for severe asthma: A systematic review of the EAACI guidelines—Recommendations on the use of biologicals in severe asthma

“…The main goal in the management of patients with severe asthma is achieving disease control and reducing risk of attacks while avoiding harm from controller therapies 1,2 . Despite extensive efforts, there is still a small proportion of patients with severe asthma insufficiently controlled with the current medications, with a significant burden due to high morbidity and costs 3‐8 . Current guidelines support the targeted approach in uncontrolled severe asthma, and several biologicals are approved for use in these patients 1,2 …”