Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

Abstract

BackgroundAsthma is one of the most common chronic respiratory conditions worldwide. Asthma-related economic burden has been reported in Latin America, but knowledge about its economic impact to the Colombian health care system and the influence of disease severity is lacking. This study estimated direct medical costs and health care resource utilization (HCRU) in patients with asthma according to severity in Colombia.MethodsThis study identified all-age patients who had at least one medical event linked to an asthma diagnosis (CIE-10: J45-J46) between 2004 and 2014. Patients were selected if they had a continuous enrollment and uninterrupted insurance coverage between January 1–2015 and December 31–2015 and were categorized into 4 different severity levels using a modified algorithm based on Leidy criteria. Healthcare utilization and costs were estimated in a 1-year period after the identification period. A Generalized Linear Model (GLM) with gamma distribution and log link was used to analyze costs adjusting for patient demographics.ResultsA total of 20,410 patients were included: 69.5% had mild intermittent, 18.0% mild persistent, 6.9% moderate persistent and 5.5% severe persistent asthma; with mean costs (SD) of $67 (134), $482 (1506), $1061 (1983), $2235 (3426) respectively (p < 0.001). The mean total direct cost was estimated at $331 (1278) per patient. Medication and hospitalization had the higher proportion in total costs (46% and 31% respectively). General physician visits was the most used service (57.2%) and short-acting β-2 agonists the most used medication (24%).ConclusionsHealth services utilization and direct costs of asthma were highly related to disease severity. Nationwide health policies aimed at the effective control of asthma are necessary and would play an important role in reducing the associated economic impact.Electronic supplementary materialThe online version of this article (10.1186/s40413-018-0205-4) contains supplementary material, which is available to authorized users.

Dispositivos de inhalación para asma y EPOC: una revisión de la literatura

“…A study that included 20,410 patients from an administrative database in Colombia estimated the mean annual cost for mild (USD $335, SD 1,489), moderate (USD $498, SD 1,940), and severe persistent (USD $865, SD 2,050) asthma for 2015. As expected, they concluded that health care services utilization and direct costs for asthma were related to disease severity (66). On the other hand a study from 2007 estimated annual costs of COPD: $2,088 USD for mild COPD, $2,853 for moderate COPD and $9,229 for severe COPD (67).…”

Availability of secondary healthcare data for conducting pharmacoepidemiology studies in Colombia: A systematic review

“…Among these, 351 articles were excluded after title screening and the abstract of the 784 remaining papers was assessed. Finally, 461 publications were excluded following the eligibility criteria and thus, 323 articles that had interpretable data and fulfilled the eligibility criteria were used for data extraction…”

Cost-effectiveness of subcutaneous house dust mite allergen immunotherapy plus pharmacotherapy for allergic asthma

“…The number of days with salbutamol use per month was obtained from a study by Sánchez et al and were multiplied with the daily dose of salbutamol used in the analysis (32). Frequency of outpatient, specialized care, ED visits and hospitalizationsper year was obtained from a study by Florez et al (3).…”

“…Allergic asthma (AA) is the most frequent phenotype and is defined by the presence of sensitization to environmental allergens. Patients with AA experience a considerable burden in terms of poor health-related quality-of-life, productivity loss and healthcare resource utilization (HCRU) that increases with severity (3).…”