Exploring asthma control cutoffs and economic outcomes using the Asthma Control Questionnaire

Area of Science:

• Pulmonary Medicine
• Health Economics
• Clinical Outcomes Research

Background:

• Asthma control significantly impacts patient expenditures and health resource utilization (HRU).
• Understanding these economic consequences is crucial for effective asthma management.
• Previous research has not fully elucidated the economic impact of specific asthma control levels.

Purpose of the Study:

• To investigate the association between economic outcomes and defined asthma control levels using the Asthma Control Questionnaire 5 (ACQ-5).
• To explore how longitudinal changes in asthma control affect healthcare expenditures and HRU.
• To establish potential ACQ-5 cutoffs for assessing economic impact.

Main Methods:

• A survey of patients with persistent asthma was conducted, collecting claims-based HRU data.
• Patients completed the ACQ-5 three times over one year.
• Generalized linear models and negative binomial regression were used to analyze expenditures and HRU, respectively, with defined ACQ-5 control categories.

Main Results:

• Cross-sectional analysis showed significantly higher oral corticosteroid prescriptions, emergency department visits, and inpatient visits for patients with poor asthma control (ACQ-5 scores 4-4.5) compared to well-controlled asthma.
• Patients with poor control incurred substantially higher all-cause and asthma-specific expenditures.
• Longitudinal analysis revealed that improving asthma control from very poorly controlled (ACQ-5 ≥3.0) to well-controlled (ACQ-5 <0.75) resulted in significant cost savings.

Conclusions:

• The study provides preliminary economic data linked to ACQ-5 control cutoffs.
• Improvements in asthma control over time are associated with significant cost reductions.
• Financial investments aimed at improving asthma control may be economically justifiable.