The direct costs of overdiagnosed asthma in a longitudinal population-based study

Ng, Bryan Cy; Sadatsafavi, Mohsen; Safari, Abdollah; Johnson, Kate

doi:10.1101/409870

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…We are aware of 1 previous economic evaluation of secondary verification of asthma. 44 In the study by Pakhale et al, 12 which was performed in the Canadian context, implementation of an asthma verification algorithm was associated with an average cost savings of $35,141 per 100 screened individuals. The main source of cost saving was medication costs, but the authors did not consider the impact of diagnostic verification and subsequent medication changes on asthma control, exacerbations, and quality of life.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of implementing objective diagnostic verification of asthma in the United States

Yaghoubi

Adibi

Zafarí

et al. 2020

Journal of Allergy and Clinical Immunology

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Background: Asthma diagnosis in the community is often made without objective testing. Objective: The aim of this study was to evaluate the cost-effectiveness of implementing a stepwise objective diagnostic verification algorithm among patients with community-diagnosed asthma in the United States. Methods: We developed a probabilistic time-in-state cohort model that compared a stepwise asthma verification algorithm on the basis of spirometry testing and a methacholine challenge test against the current standard of care over 20 years. Model input parameters were informed from the literature and with original data analyses when required. The target population was US adults (> _15 years old) with physician-diagnosed asthma. The final outcomes were costs (in 2018 dollars) and quality-adjusted life years (QALYs), discounted at 3% annually. Deterministic and probabilistic analyses were undertaken to examine the effect of alternative assumptions and uncertainty in model parameters on the results. Results: In a simulated cohort of 10,000 adults with diagnosed asthma, the stepwise algorithm resulted in removal of the diagnosis of 3,366. This was projected to be associated with savings of $36.26 million in direct costs and a gain of 4,049.28 QALYs over 20 years. Extrapolating these results to the US population indicated an undiscounted potential savings of $56.48 billion over 20 years. The results were robust against alternative assumptions and plausible changes in values of input parameters. Conclusion: Implementation of a simple diagnostic testing algorithm to verify asthma diagnosis might result in substantial savings and improvement in patients' quality of life.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of implementing objective diagnostic verification of asthma in the United States

Yaghoubi

Adibi

Zafarí

et al. 2020

Journal of Allergy and Clinical Immunology

Self Cite

View full text Add to dashboard Cite

show abstract

“…We are aware of one previous economic evaluation of secondary verification of asthma 38 . In the study by Pakhale et al, which was performed in the Canadian context, implementation of an asthma verification algorithm was associated with an average cost savings of $35,141 per 100 screened individuals.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of implementing objective diagnostic verification of asthma in the United States

Yaghoubi

Adibi

Zafarí

et al. 2019

Preprint

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View full text Add to dashboard Cite

Background: Asthma diagnosis in the community is often made without objective testing. Objective: The aim of this study was to evaluate the cost-effectiveness of implementing a stepwise objective diagnostic verification algorithm among patients with community-diagnosed asthma in the United States (US). Methods: We developed a probabilistic time-in-state cohort model that compared a stepwise asthma verification algorithm based on spirometry and methacholine challenge test against the current standard of care over 20 years. Model input parameters were informed from the literature and with original data analyses when required. The target population was US adults (15 y/o or older) with physician-diagnosed asthma. The final outcomes were costs (in 2018 $) and quality-adjusted life years (QALYs), discounted at 3% annually. Deterministic and probabilistic analyses were undertaken to examine the effect of alternative assumptions and uncertainty in model parameters on the results. Results: In a simulated cohort of 10,000 adults with diagnosed asthma, the stepwise algorithm resulted in the removal of diagnosis in 3,366. This was projected to be associated with savings of $36.26 million in direct costs and a gain of 4,049.28 QALYs over 20 years. Extrapolating these results to the US population indicated an undiscounted potential savings of $56.48 billion over 20 years. Results were robust against alternative assumptions and plausible changes in values of input parameters. Conclusion: Implementation of a simple diagnostic testing algorithm to verify asthma diagnosis might result in substantial savings and improvement in patients quality of life.

show abstract

The direct costs of overdiagnosed asthma in a longitudinal population-based study

Abstract: Word Count: 262 Word Count: 2836 (excluding abstract, references, tables, appendices, and figure legends)

Cited by 2 publications

References 22 publications

Cost-effectiveness of implementing objective diagnostic verification of asthma in the United States

Cost-effectiveness of implementing objective diagnostic verification of asthma in the United States

Cost-effectiveness of implementing objective diagnostic verification of asthma in the United States

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