Cost of severe asthma in Brazil—systematic review

Stirbulov, Roberto; Silva, Nilceia Lopes da; Maia, Sarah Cristina Oliveira Machado; Carvalho-Netto, Eduardo F.; Angelini, Luciene

doi:10.3109/02770903.2016.1171338

Cited by 17 publications

(20 citation statements)

References 18 publications

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“…A recent systematic review of the costs of severe asthma in Brazil showed that the major direct expenses were related to hospitalizations and medications and that USD 733.00 were spent per patient per year, highlighting the elevated economic costs of asthma. 32 …”

Section: Discussionmentioning

confidence: 99%

The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system

et al. 2017

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Objective:To present official longitudinal data on the impact of asthma in Brazil between 2008 and 2013. Methods:This was a descriptive study of data collected between 2008 and 2013 from an official Brazilian national database, including data on asthma-related number of hospitalizations, mortality, and hospitalization costs. A geographical subanalysis was also performed. Results:In 2013, 2,047 people died from asthma in Brazil (5 deaths/day), with more than 120,000 asthma-related hospitalizations. During the whole study period, the absolute number of asthma-related deaths and of hospitalizations decreased by 10% and 36%, respectively. However, the in-hospital mortality rate increased by approximately 25% in that period. The geographic subanalysis showed that the northern/northeastern and southeastern regions had the highest asthma-related hospitalization and in-hospital mortality rates, respectively. An analysis of the states representative of the regions of Brazil revealed discrepancies between the numbers of asthma-related hospitalizations and asthma-related in-hospital mortality rates. During the study period, the cost of asthma-related hospitalizations to the public health care system was US$ 170 million. Conclusions:Although the numbers of asthma-related deaths and hospital admissions in Brazil have been decreasing since 2009, the absolute numbers are still high, resulting in elevated direct and indirect costs for the society. This shows the relevance of the burden of asthma in middle-income countries.

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Section: Discussionmentioning

confidence: 99%

The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system

et al. 2017

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“…The authors emphasized that the indirect costs due to work productivity losses further increase the burden of disease. Other authors have analyzed the cost of severe asthma from the perspective of the Brazilian public health system 27 , describing a mean annual cost due to hospital admissions of 764-929 USD. The authors concluded that hospitalizations and drug treatments are the most important costs and underlined that further representative severe asthma cost studies in Brazilian patients are needed.…”

Section: Discussionmentioning

confidence: 99%

Real-life retrospective observational study to determine the prevalence and economic burden of severe asthma in Spain

Sicras‐Mainar¹,

Capel

Navarro‐Artieda

et al. 2020

Journal of Medical Economics

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Objective: We determined the percentage of patients with severe asthma and exacerbations and evaluated the costs of the disease based on blood eosinophil counts. Methods: A retrospective observational study based on the review of medical records in Spain was carried out. Patients !18 years of age requiring care during the years 2014-2015; diagnosed with asthma with at least 2 years of continuous records (at least one year prior to the index date defined as the first asthma medication prescription and at least one year after the index date) were included. Study groups: eosinophil counts <300 cells/ll and !300 cells/ll. Main variables: comorbidity, clinical parameters, exacerbations and annual asthma total costs. Results: A total of 268 severe asthmatic patients in Spain were included, representing 6.3% of the asthma population, with 58.6% having eosinophil count !300 cells/ll and 41.4% eosinophil count <300 cells/ll. The mean age was 56.1 years (63.4% women). Patients with eosinophilic inflammation (!300 cells/ll) had lower FEV1 values (54.3% vs. 60.7%; p < .001), poorer treatment adherence (65.6% vs. 77.3%; p < .001), and a greater mean number of exacerbations (3.3 vs. 1.9; p < .001). Exacerbations were correlated to FEV1 (b¼-.606), eosinophils (b ¼ .255), immunoglobulin E (b ¼ .152), and age (b ¼ .128), p < .001. The mean total asthma annual cost (ANCOVA) was 6222 vs. 4152 euros, respectively (p ¼ .016). Health costs were associated with age (b ¼ .323), FEV1 (b ¼ .239), eosinophils (b ¼ .177) and exacerbations (b ¼ .158), p < .01. Limitations: Those inherent to retrospective studies; the possible inaccuracy of diagnostic coding referring to severe asthma and other comorbidities and the external validity of the results. Conclusions: Health costs of patients with severe asthma were high. Total annual asthma costs and resource use were greater in patients with !300 cells/ll. Age, eosinophilia, exacerbations and FEV1 were associated with greater resource utilization and costs for the health system.

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“…Few studies are published in Brazil with primary data on the costs of chronic diseases, and most of them refer to cardiovascular diseases, such as chronic coronary artery disease 20 and congestive heart failure 3 . A recent systematic review has included only three studies on the costs of asthma in Brazil, all focusing only on severe asthma, showing the scarcity of data in the country 25 . Our study provides an estimate of the cost of bronchial asthma in a real-life setting with outpatients with different levels of severity and control, not yet described in Brazil.…”

Section: Discussionmentioning

confidence: 99%

Estimativa de custo da asma em tratamento ambulatorial: estudo com dados de mundo real

et al. 2018

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OBJECTIVE To estimate the cost of diagnosis and treatment of asthma.METHODS We used the perspective of society. We sequentially included for 12 months, in 2011-2012, 117 individuals over five years of age who were treated for asthma in the Pneumology and Allergy-Immunology Services of the Piquet Carneiro Polyclinic, Universidade do Estado do Rio de Janeiro. All of them were interviewed twice with a six-month interval for data collection, covering 12 months. The cost units were identified and valued according to defined methods. We carried out a sensitivity analysis and applied statistical methods with a significance level of 5% for cost comparisons between subgroups.RESULTS The study consisted of 108 patients, and 73.8% of them were women. Median age was 49.5 years. Rhinitis was present in 83.3% of the individuals, and more than half were overweight or obese. Mean family income was U$915.90/month (SD = 879.12). Most workers and students had absenteeism related to asthma. Total annual mean cost was U$1,291.20/patient (SD = 1,298.57). The cost related to isolated asthma was U$1,155.43/patient-year (SD = 1,305.58). Obese, severe, and uncontrolled asthmatic patients had higher costs than non-obese, non-severe, and controlled asthmatics, respectively. Severity and control level were independently associated with higher cost (p = 0.001 and 0.000, respectively). The direct cost accounted for 82.3% of the estimated total cost. The cost of medications for asthma accounted for 62.2% of the direct costs of asthma.CONCLUSIONS Asthma medications, environmental control measures, and long-term health leaves had the greatest potential impact on total cost variation. The results are an estimate of the cost of treating asthma at a secondary level in the Brazilian Unified Health System, assuming that the treatment used represents the ideal approach to the disease.

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Cost of severe asthma in Brazil—systematic review

Cited by 17 publications

References 18 publications

The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system

The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system

Real-life retrospective observational study to determine the prevalence and economic burden of severe asthma in Spain

Estimativa de custo da asma em tratamento ambulatorial: estudo com dados de mundo real

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