Direct and Indirect Costs of Asthma Management in Greece: An Expert Panel Approach

Abstract

ObjectiveAsthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma.MethodsA Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns. Unit costs from official, published sources were subsequently assigned to resource use to estimate direct medical costs. Indirect costs were estimated as number of work loss days. Cost base year was 2015, and the perspective adopted was that of the National Organization of Health Care Services Provision, as well as the societal.ResultsPatients with asthma are mainly managed by pulmonologists (71.4%) and secondarily by general practitioners and internists (28.6%). The annual cost of managing exacerbations was estimated at €273.1, while maintenance costs were estimated at €1,100.2 per year. Total costs of managing asthma per patient per year were estimated at €2,281.8, 64.4% of which represented direct medical costs. Of the direct costs, pharmaceutical treatment was the key driver, accounting for 63.9 and 41.2% of direct and total costs, respectively. Direct non-medical costs (patient travel and waiting time) were estimated at €152.3. Indirect costs accounted for 28.9% of total costs.ConclusionAsthma is a chronic condition, the management of which constrains the already limited Greek health care resources. The increasing prevalence of the disease raises concerns as it could translate per patient costs into a significant burden for the Greek health care system. Thus, the prevention, self-management, and improved quality of care for asthma should find a place in the health policy agenda in Greece.

Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma

“…To the best of our knowledge this is the first study investigating not only the clinical benefits, but also the economic impact of switching to MEP patients not optimally controlled by OMA. The economic analysis included both direct health care costs (drug consumption, hospitalizations, diagnostic exams, unscheduled visits) and indirect costs (absenteeism due to disease), that represented a significant portion of the total burden of asthma 32 , 33 . According to our findings, productivity loss accounted for about 22% of the annual cost due to uncontrolled asthma (excluding OMA cost); such percentage decreased to 9% after one year of treatment with MEP (excluding MEP cost).…”

Establishing a pulmonary rehabilitation programme in primary care in Greece: A FRESH AIR implementation study

“…3 CRDs are also responsible for substantial costs for Greek patients and the healthcare system, with the total annual costs of managing COPD and asthma (including medications and hospitalizations) reaching 4730 and 2281 euros per patient, respectively. 4,5 Further to their economic impact, CRDs constitute an important issue for the quality of life and work productivity of patients in Greece. Specifically, annual per patient productivity losses exceed 900 euros for COPD 4 and 600 euros for asthma, 5 while disability adjusted life years are estimated at 0.2 for COPD and 0.4 for asthma per 1000 capita per year.…”

“…4,5 Further to their economic impact, CRDs constitute an important issue for the quality of life and work productivity of patients in Greece. Specifically, annual per patient productivity losses exceed 900 euros for COPD 4 and 600 euros for asthma, 5 while disability adjusted life years are estimated at 0.2 for COPD and 0.4 for asthma per 1000 capita per year. 6 Despite the above, integrated services for patients with CRDs, including pulmonary rehabilitation (PR), are largely absent in the country, especially at the primary care setting.…”

Cost-effectiveness analysis of anti–IL-5 therapies of severe eosinophilic asthma in Spain

“…Direct costs related to asthma management are mostly driven by medication costs, which are attributable to 45%-84% of direct costs in Europe, and 51%-68% in North America. (Souliotis et al, 2017) Severe asthma patients have been estimated to accrue annual costs ranging between €7,411-10,199 per patient in Spain (Melero Moreno et al, 2019).…”