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Economic burden of impairment in children with severe or difficult-to-treat asthma
Stanley J Szefler1, Robert S Zeiger, Tmirah Haselkorn
1National Jewish Health, Denver, Colorado, USA.
Insights
The annual cost of severe asthma in children is over double for those with very poorly controlled asthma compared to well-controlled asthma. Improving asthma control significantly reduces healthcare costs.
Area of Science:
- Pediatric Pulmonology
- Health Economics
- Asthma Management
Background:
- The economic impact of severe asthma impairment in children remains largely undetermined.
- Understanding the cost burden is crucial for resource allocation and developing targeted interventions.
Purpose of the Study:
- To quantify the asthma cost burden in children with severe or difficult-to-treat asthma.
- To evaluate the relationship between asthma impairment levels and associated healthcare costs.
Main Methods:
- Utilized data from 628 children (aged 6-12) in a longitudinal asthma study.
- Categorized children into very poorly controlled (VPC), not well controlled (NWC), or well controlled (WC) based on asthma impairment.
- Assessed direct (medications, visits, hospitalizations) and indirect (school/work days lost) asthma costs cross-sectionally and longitudinally.
Main Results:
- Mean annual total asthma costs were over twice as high in the VPC group ($7,846 baseline, $7,326 month 12, $8,879 month 24) compared to NWC and WC groups.
- Indirect costs constituted approximately half of the total costs for VPC asthma patients.
- Significant cost reductions were observed when asthma impairment status improved from VPC.
Conclusions:
- The economic burden of severe pediatric asthma is substantial, particularly in children with very poorly controlled asthma.
- Improving asthma control is directly associated with a significant reduction in healthcare-related costs.
- Enhanced management strategies and effective medications for poorly controlled asthma are essential to mitigate this economic burden.
Background:
The cost associated with asthma impairment in children with severe asthma has not been determined.
Objective:
To assess the asthma cost burden in children with severe or difficult-to-treat asthma based on asthma impairment.
Methods:
Children aged 6 to 12 years in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study with available data at baseline (n = 628), month 12 (n = 385), and month 24 (n = 280) corresponding to the National Heart, Lung, and Blood Institute asthma guidelines' impairment domain were included. Children were categorized as either very poorly controlled (VPC), not well controlled (NWC), or well controlled (WC) and assessed cross-sectionally and longitudinally. Mean total asthma costs based on direct (medication usage, unscheduled office visits, emergency department visits, hospitalizations) and indirect (school/work days lost) asthma costs were assessed.
Results:
Mean annual total asthma costs were more than twice as high in the VPC group compared with NWC and WC groups (baseline: $7,846, $3,526, $3,766.44, respectively; month 12: $7,326, $2,959, $2,043, respectively; month 24: $8,879, $3,308, $1,861, respectively (all P < .001). Indirect costs accounted for approximately half the total asthma costs for VPC asthma patients at each time point. Significantly lower costs were observed for patients whose impairment status improved or temporarily improved from VPC after baseline.
Conclusion:
The economic burden of severe or difficult-to-treat asthma in children is associated with VPC asthma and improvement in asthma control and is associated with reducing cost. Further attention to patients with poorly controlled asthma, through better management strategies or more effective medications, may significantly reduce this burden of illness.
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