NEW ORLEANS – Children's school absences and their parents' absences from work represented the greatest economic burden of impairment in children with severe asthma, according to data from an observational study of more than 600 children.
“Asthma costs in the United States have exceeded $10 billion,” said Dr. Stanley J. Szefler of National Jewish Health in Denver, and his colleagues at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. That figure includes $4.6 billion in indirect costs, such as mortality and lost school and work days, and $6.1 billion in direct costs, such as medications and hospital stays.
Dr. Szefler and his colleagues examined whether improvements in asthma impairment in young children reduced the cost burden of asthma. The study was the first to assess the economic burden of asthma in children aged 6-12 years with severe or difficult-to-treat illness as defined by the National Heart, Lung, and Blood Institute's guidelines, the researchers said.
The study included 628 children aged 6 years and older with severe or refractory asthma. At baseline, 386 children had very poorly controlled (VPC) asthma, 219 had not well-controlled (NWC) asthma, and 23 had well-controlled (WC) asthma. The children were a subgroup of the TENOR study, a large, observational study that assessed patients with severe and difficult-to-treat asthma. A total of 62% of the children were classified as VPC, the researchers noted.
The researchers compared the cumulative costs for patients who were consistently VPC at baseline, 12 months, and 24 months with the costs for patients who improved over the 24-month study period. Primary outcomes included school days lost, cost of asthma medications, unscheduled doctor visits, overnight hospital stays, and emergency department visits.
Overall, the cost of school and work days lost in the VPC group at baseline, 12 months, and 24 months was $3,087, $3,139, and $4,277, respectively. Those costs were significantly higher than for the NWC group ($369, $251, and $478, respectively) and the WC group ($0, $166, $0, respectively). The costs of school absences were measured using gender-specific dollar amounts to represent a parent's lost work day and adjusted to 2002 dollars.
The costs of medications were the next largest contributor to cost burden. Medication costs in the VPC group at baseline ($2,117), 12 months ($2,312), and 24 months ($2,298) were significantly higher than in the NWC group ($1,949, $1,987, and $1,995, respectively) and the WC group ($1,861, $1,640, and $1,605). The costs of medications were measured using the average recommended daily dose.
“The highest costs were associated with patients whose asthma impairment status remained consistently VPC,” the researchers wrote.
The study was sponsored by Genentech Inc. Dr. Szefler received funding from several organizations that are sponsored by the National Institutes of Health, as well as from several pharmaceutical companies.
Source Elsevier Global Medical News