A comprehensive study of the direct and indirect costs of adult asthma

Cisternas, Miriam G.; Blanc, Paul D.; Yen, Irene H.; Katz, Patricia P.; Earnest, Gillian; Eisner, Mark D.; Shiboski, Stephen; Yelin, Edward H.

doi:10.1067/mai.2003.1449

Cited by 244 publications

(168 citation statements)

References 24 publications

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“…Although there would be an increase in cost with the acquisition of medicines, the total direct cost would be reduced by decreasing unscheduled visits, emergency attendance and hospitalization. Moreover, this recommended management of the disease avoids dangerous consequences for under treated asthma patients (24,25). One of the limitations of the present study is the difficulty to compare the amount of money spent due to differences in economic systems.…”

Section: Discussionmentioning

confidence: 87%

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Santos

Oliveira

Faresin

et al. 2007

Braz J Med Biol Res

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Asthma is a common chronic illness that imposes a heavy burden on all aspects of the patient's life, including personal and health care cost expenditures. To analyze the direct cost associated to uncontrolled asthma patients, a cross-sectional study was conducted to determine costs related to patients with uncontrolled and controlled asthma. Uncontrolled patient was defined by daytime symptoms more than twice a week or nocturnal symptoms during two consecutive nights or any limitations of activities, or need for relief rescue medication more than twice a week, and an ACQ score less than 2 points. A questionnaire about direct cost stratification in health services, including emergency room visits, hospitalization, ambulatory visits, and asthma medications prescribed, was applied. Ninety asthma patients were enrolled (45 uncontrolled/45 controlled).

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Section: Discussionmentioning

confidence: 87%

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Santos

Oliveira

Faresin

et al. 2007

Braz J Med Biol Res

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“…Costs-Costs were estimated from published resource use studies [29][30][31][32][33][34][35][36] and adjusted to reflect US 2005 dollars by using the Consumer Price Index. 21 Baseline monthly chronic care costs (medications, routine office visits, laboratory testing) were $77 for patients with severe disease.…”

Section: Input Data: Effect Of Omalizumab Therapymentioning

confidence: 99%

Cost-effectiveness of omalizumab in adults with severe asthma: Results from the Asthma Policy Model

Paltiel

Kuntz³

et al. 2007

Journal of Allergy and Clinical Immunology

103

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“…We didnot includecostsassociatedwith self-treatment usingo ver-the-countero ra lternative remedies, burden on family members,a nd loss of productivity 9,47 ;t hus, cautioni sa dvised in generalizing thee stimated treatment costsf romt hiss tudy.As ixth limitationi st he calculationo f incrementaltreatment costsbased on ashort follow-upperiod of 1yearafter AM diagnosis. Nonetheless,thislimitationmay have minimale ffect on cost estimation because incremental costswerecalculatedasthe differenceincostsbeforeand after developingAMs in thesamep atient to minimize inter-patient variation.…”

Section: Limitationsmentioning

confidence: 99%

Economic Burden of Atopic Manifestations in Patients With Atopic Dermatitis - Analysis of Administrative Claims

Suh¹,

Sung²,

Gause³

et al. 2007

JMCP

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BACKGROUND: Atopic dermatitis (AD) has been associated with atopic manifestations (AMs), such as food allergies, asthma, allergic rhinitis, and allergic conjunctivitis.OBJECTIVES: To (1) compare the risk of developing AMs in patients with AD versus those without AD, (2) estimate the incremental costs attributable to AMs in patients with AD, and (3) examine the factors associated with incremental costs.METHODS: In this retrospective cohort study, the authors used MarketScan research databases containing medical and pharmacy claims with dates of service from January 1, 1999, to December 31, 2004. Patients were considered to have AD if they had at least 1 medical claim with a primary or secondary diagnosis of AD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 691.8x) or contact dermatitis or other eczema of unspecified cause (ICD-9-CM codes 692.9x). To create comparable study cohorts, patients with AD were matched with non-AD patients using propensity scores that represented the likelihood of developing AD as predicted by logistic regression. After propensity score matching, the AD and non-AD cohorts did not statistically differ with respect to age, gender, geographic region, type of health insurance, Charlson Comorbidity Index, or baseline measures of medical and prescription drug utilization. The relative risks of developing AMs in the AD and non-AD cohorts were estimated using competing risk-survival analysis. AM was defined by ICD-9-CM codes for asthma (493.xx), allergic rhinitis (477.xx), allergic conjunctivitis (372.05 or 372.14), and food allergy (693.1x, 692.5x, 995.60). The annual incremental cost attributable to AMs in these AD patients was calculated from medical claims with AM and AD diagnosis codes and from pharmacy claims for prescription drugs used to treat asthma, allergic rhinitis, allergic conjunctivitis, or food allergy, and 95% confidence intervals (CIs) were calculated using the bootstrap method.RESULTS: Patients with AD were significantly more likely to develop AMs than patients without AD (21.8% versus 16.9%, adjusted relative risk [RR] = 1.33, 95% CI, 1.28-1.38). Among AD patients who developed AMs, allergic rhinitis was the most frequent manifestation (66.3%), followed by asthma (24.8%), allergic conjunctivitis (7.6%), and food allergy (1.8%). The incidence and adjusted RRs of developing AM for AD patients versus comparison patients were 5.3% versus 4.5% for asthma (RR = 1.20, 95% CI, 1.12-1.29), 14.6% versus 11.2% for allergic rhinitis (RR = 1.35, 95% CI, 1.29-1.41), 1.6% versus 1.1% for allergic conjunctivitis (RR = 1.50, 95% CI, 1.31-1.72), and 0.3% versus 0.1% for food allergy (RR = 2.35, 95% CI, 1.66-3.32). The annual AD + AM treatment costs for patients with AD increased substantially after they developed AMs. The additional financial burden attributable to AMs was estimated to be $482 per year, an almost 1.5-fold increase compared with AD cost alone (from $338 before AM development to $820 afterward, P < 0.001), with approxima...

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A comprehensive study of the direct and indirect costs of adult asthma

Cited by 244 publications

References 24 publications

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Cost-effectiveness of omalizumab in adults with severe asthma: Results from the Asthma Policy Model

Economic Burden of Atopic Manifestations in Patients With Atopic Dermatitis - Analysis of Administrative Claims

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