Guideline-based asthma treatment in Asia: Insights from a robust time-in-state model

Area of Science:

• Pulmonary Medicine
• Health Economics
• Public Health

Background:

• Guideline-based asthma management in Asia lacks comprehensive data.
• Understanding the economic and humanistic impact of current asthma treatment is crucial.

Purpose of the Study:

• To predict the long-term economic impact of guideline-based asthma treatment in Asian countries.
• To use Singapore as a case study for modeling asthma treatment outcomes.

Main Methods:

• Systematic review of asthma prevalence, inhaled corticosteroid (ICS)/ICS-long-acting beta-agonist (LABA) adherence, and short-acting beta-agonist (SABA) use in Asian populations (2014-2024).
• Development of a time-in-state model to assess the impact of adherence and SABA use on uncontrolled asthma burden (2024-2043).
• Projection of 20-year direct costs, indirect costs, and quality-adjusted life-years (QALYs) lost in Singapore.

Main Results:

• Asthma prevalence in Asia ranges from 1-14%.
• Reported ICS/ICS-LABA adherence varied widely (10-90%), with average SABA use of 2.5-6.4 canisters/year.
• In Singapore, uncontrolled asthma is projected to cost SGD$2.772 billion (direct), SGD$5.670 billion (indirect), and 58,872 QALYs lost over 20 years under current trends. Optimizing treatment could reduce these by 27.7%, 23.8%, and 28.8%, respectively.

Conclusions:

• Population-based evidence on guideline-based asthma treatment in Asia is limited.
• Economic modeling indicates substantial reductions in societal burden are achievable through optimized asthma management.
• Findings highlight the potential for significant economic and humanistic benefits in Asian countries like Singapore.