Cost of asthma in Portuguese adults: A population-based, cost-of-illness study

Barbosa, José Pedro; Ferreira-Magalhães, Manuel; Sá‐Sousa, Ana; Azevedo, Luís Filipe; Fonseca, João

doi:10.1016/j.rppnen.2017.07.003

Cited by 19 publications

(27 citation statements)

References 14 publications

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“…We found that the worst case scenario for cost savings could represent a slight negative balance, but that could be underestimated. In fact, for that estimation we used data from a Portuguese study on asthma, but we only considered acute medical care costs that represent about 40% of patients included. However, the real prevalence of exacerbations in older patients is slightly higher.…”

Section: Discussionmentioning

confidence: 99%

“…Absolute mean reductions of exacerbation rates range from 0.07 to 0.22, in worst and best case scenarios and according to 95% confidence interval (CI) limits . In addition, exacerbations and acute medical care, alone, represent annual costs between 330€ (US $290.69) and 8000€ (US $7047.30) per patient . A more recent estimation for COPD in Portugal points out annual costs of 2250€ (US $1982.04) per patient .…”

Section: Methodsmentioning

confidence: 99%

“…Inhaled therapy is the main treatment pathway used, but most patients use devices incorrectly, frequently with critical errors, thereby contributing to poor clinical control and increased risk of exacerbations . In addition, many studies showed that poor clinical control also leads to increased costs in health services . However, true estimates of the burden due to asthma and COPD are unavailable because direct and indirect costs are difficult to quantify, and different parts of the world report different estimations.…”

mentioning

confidence: 99%

“…[2][3][4][5] In addition, many studies showed that poor clinical control also leads to increased costs in health services. [6][7][8][9] However, true estimates of the burden due to asthma and COPD are unavailable because direct and indirect costs are difficult to quantify, and different parts of the world report different estimations.…”

mentioning

confidence: 99%

“…In addition, strong evidence supports the cost-effectiveness of those programs, although the reported results show a broad range of annual cost savings with interventions, ranging from 200€ (US $176.17) to 2000€ (US $1761.70) per patient. [15][16][17][18][19][20] In Portugal, acute care and exacerbations-associated annual costs are estimated between 330€ (US $290.69) and 8000€ (US $7047.30) per patient, 7,21 but no study has yet evaluated the cost-effectiveness of a conceptualized national education program for asthma and COPD.…”

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confidence: 99%

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Inhaler Review in Older Adults with Asthma or COPD: A Cost‐Effectiveness Study and a Perspective in Portugal

Maricoto

Marques‐Gomes

Sousa

et al. 2019

J American Geriatrics Society

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OBJECTIVES Older patients with asthma or chronic obstructive pulmonary disease are particularly susceptible to exacerbations that may be associated with incorrect use of inhalers. Educational programs with inhaler technique review seem to be effective, but no studies have addressed their cost‐effectiveness in older adult patients. The objective was to perform a cost‐effectiveness analysis of education programs in older patients and estimate the cost benefit of applying such a program in Portugal. DESIGN We developed a decision tree analysis from a healthcare perspective, according to intervention costs and the exacerbation rates and costs described in a previous meta‐analysis. A sensitivity analysis of worst and best case scenarios was performed to estimate thresholds for intervention affordable limits, as well as cost‐saving estimations and incremental cost‐effectiveness ratios (ICERs) for a Portuguese scenario. SETTING AND PARTICIPANTS We estimated cost‐effectiveness thresholds applicable in all settings and performed a sensitivity analysis of a theoretical intervention model in all patients including an inhaler technique review at an annual appointment with a doctor and a nurse. RESULTS In the best case scenario, the intervention affordable budget could be up to almost 1800€ (US $1585.24) per patient per year. Mean intervention‐associated savings in Portugal would be 311.88€ (US $274.68) per patient per year, representing annual savings up to €131 million (US $150 million) for the whole health system, already including intervention costs. ICERs for Portugal vary between 93.73€ (US $82.55) and 437.43€ (US $385.25) per exacerbation avoided. CONCLUSION A model of an intervention program with an inhaler technique review in older adult patients suggests that this intervention is cost‐effective and can generate significant savings. J Am Geriatr Soc 1–7, 2019.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Inhaler Review in Older Adults with Asthma or COPD: A Cost‐Effectiveness Study and a Perspective in Portugal

Maricoto

Marques‐Gomes

Sousa

et al. 2019

J American Geriatrics Society

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Regional, sex, and age inequities in asthma hospital admissions in Spain and Portugal

Vieira,

Pereira,

Taborda‐Barata

et al. 2024

Clinical & Translational All

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BackgroundAsthma presents a significant health challenge, imposing a considerable burden on healthcare services. Discrepancies in asthma‐related hospitalisations may reflect underlying health disparities. We aimed to analyse inequities in asthma hospital admissions in mainland Portugal and Spain, from a regional perspective and considering sex and age.MethodsWe conducted a retrospective study using data from the Spanish and Portuguese national hospitalisations databases. We calculated crude national and regional yearly hospitalisation rates according per Nomenclature of Territorial Units for Statistics region. Additionally, we calculated hospitalisation rates adjusted for asthma prevalence and the female‐to‐male ratio in asthma hospital admissions per age group, considering the female‐to‐male ratio in the overall population.ResultsBetween 2012 and 2016, there were 92,084 asthma hospital admissions in mainland Spain and 7717 in mainland Portugal. There was a trend for a higher‐than‐average rate of asthma‐related hospitalisations in the Northern regions of both countries. Women had a hospitalisation rate that was 3.2 times higher than men. Age was associated with higher risk for asthma hospitalisation, with individuals aged 65 and older displaying a hospitalisation rate 4.5 times higher than those under 65. Additionally, while hospitalisations in women aged <65 years were 2.3 times more likely than in men of the same age, hospitalisations in women aged ≥65 years were 3.5 times higher than in men aged ≥65 years.ConclusionThis study suggests that marked regional inequities in asthma hospital admissions exist in Spain and Portugal. Additionally, women are particularly at risk of hospitalisation due to asthma, and such risk increases with age.

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The cost-effectiveness of as-needed budesonide/formoterol versus low-dose inhaled corticosteroid maintenance therapy in patients with mild asthma in the UK

FitzGerald

Arnetorp

Smare

et al. 2020

Respiratory Medicine

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Cost of asthma in Portuguese adults: A population-based, cost-of-illness study

Cited by 19 publications

References 14 publications

Inhaler Review in Older Adults with Asthma or COPD: A Cost‐Effectiveness Study and a Perspective in Portugal

Inhaler Review in Older Adults with Asthma or COPD: A Cost‐Effectiveness Study and a Perspective in Portugal

Regional, sex, and age inequities in asthma hospital admissions in Spain and Portugal

The cost-effectiveness of as-needed budesonide/formoterol versus low-dose inhaled corticosteroid maintenance therapy in patients with mild asthma in the UK

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