Disease management program for asthma: baseline assessment of resource use

Area of Science:

• Pulmonary Medicine
• Health Services Research
• Pharmacoeconomics

Background:

• Asthma disease management programs require understanding patient resource utilization.
• Previous assessments of asthma patient resource use are limited.
• Variances in medication use from clinical guidelines impact healthcare costs.

Purpose of the Study:

• To assess healthcare resource utilization among asthma patients.
• To identify variances from clinical guidelines in asthma medication use.
• To inform the development of a disease management program.

Main Methods:

• Retrospective review of 656 asthma patients' medication profiles and medical records from a health maintenance organization (HMO) in 1993.
• Exclusion of patients with chronic obstructive pulmonary disease.
• Determination of healthcare resource use (visits, admissions, costs) and comparison with pharmacy benefit management (PBM) clinical guidelines.

Main Results:

• Young children (0-4 years) exhibited the highest outpatient and emergency care visits and hospital admissions.
• Patients receiving high-dose beta-agonist therapy (44 patients) had significantly higher healthcare utilization and costs.
• Mean healthcare cost for asthma patients was $203, compared to $110 for all HMO enrollees; high beta-agonist users incurred nearly three times the cost of other asthma patients.
• Identified medication use variances from established asthma treatment guidelines.

Conclusions:

• Significant variations exist in asthma patient resource use and medication management.
• High-dose beta-agonist use, particularly without anti-inflammatory or corticosteroid co-therapy, is associated with increased healthcare costs.
• Findings highlight opportunities for optimizing asthma disease management programs and adherence to clinical guidelines.