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01-08-2019 | Respiratory | News | Article

Improved asthma control offers potential for sizeable cost savings

medwireNews: Researchers have projected that the economic burden of uncontrolled asthma in the USA will be in excess of US$ 900 billion over the next 20 years.

“Given that a substantial fraction of this burden is preventable, better adherence to evidence-informed asthma management strategies by care providers and patients has the potential to substantially reduce costs and improve quality of life,” say J Mark FitzGerald (The University of British Columbia, Vancouver, Canada) and colleagues.

The team created a probabilistic model to make projections for 2019–2038 that incorporated forecasts of population growth and aging, estimates of asthma prevalence from the Global Burden of Disease studies conducted in 2016, and asthma control levels based on the Asthma Control Test from the US National Health and Wellness Survey from 2011–2013.

They also included healthcare resource use and quality-adjusted life years (QALYs) based on literature reviews and meta-analyses, and performed model calibration to convert estimates of resource use to direct costs based on 2018 dollar rates, and predicted productivity loss in terms of asthma control based on pooled estimates of work time lost.

As reported in the American Journal of Respiratory and Critical Care Medicine, the direct costs associated with uncontrolled asthma are estimated to be $ 14.62 billion in 2019, increasing to $ 15.08 in 2028 and $ 15.23 billion in 2038.

This represents a 4.2% growth over the 20-year period, the researchers report, during which time they predict the total direct costs associated with uncontrolled asthma to be $ 300.65 billion.

“Our results therefore indicate that around 20% of direct costs of asthma can potentially be prevented by achieving asthma control in this population,” the team notes.

FitzGerald and co-workers continue: “Indeed, strategies and interventions towards better asthma control are likely to be associated with costs, and are unlikely to result in complete asthma control in all patients.

“As such, these values can be seen as population-based estimates of the maximum potential return on investment from strategies that are aimed at improving asthma control,” they say.

The indirect costs associated with uncontrolled asthma were estimated to increase by 4.0% over the 20-year period, from $ 32.2 billion in 2019 to $ 33.5 billion in 2038, bringing the total excess costs to $ 662.9 billion.

In terms of productivity, the team estimated a total of 752,230 QALYs lost to uncontrolled asthma in 2019, rising to 775,791 in 2028 and 783,474 in 2038, representing a 4.2% increase in the next 20 years at an overall total of 15.46 million QALYs.

The researchers explain that their study assumes that the overall prevalence of asthma across men and women of different ages will stay the same, but it is likely that the contribution of risk factors will change over time.

Given the findings, the researchers emphasize that “[r]esearch into improving adherence to existing medications should be put on an equal footing with investments in novel asthma therapies,” noting that “[m]any of the effective asthma therapies are now off-patent, and research and development in the private sector are understandably shifted towards developing novel therapies.”

However, they conclude that “healthcare management organizations, patient groups, governments, and society at large, will benefit from investing in areas with proven capacities for improving patient outcomes and reducing costs.”

By Lucy Piper, Senior medwireNews Reporter

medwireNews ( is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

Am J Respir Crit Care Med 2019; doi:10.1164/rccm.201901-0016OC  

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