Par16: Cost of Treating Asthma in a Managed Care Population

Abstract

OBJECTIVES: Asthma is a common medical condition that is increasing in prevalence. The purpose of this study was to examine costs associated with treating asthma patients within a managed care organization (MCO). METHODS: Data for this study were obtained from a managed care organization located in the Western region of the US. Patients were eligible for inclusion if they met one of the following criteria: a diagnosis of asthma (ICD‐9 code of 493.xx); two or more prescriptions used to control asthma (e.g., inhaled corticosteroid, leukotriene modifier, mast cell stabilizer, xanthine derivative, or a long acting beta agonist); or one prescription for an asthma controller and one or more prescriptions for a short acting beta‐agonist. Patients also had to be full year members of the MCO. Patients with a diagnosis of chronic obstructive lung disease were excluded. RESULTS: A total of 351,140 persons were continuously enrolled in the MCO during 1999. A total of 8,051 persons were identified as having asthma (2.3% of the MCO enrollees), with 43% being male. Persons under 18 years of age comprised 28.8% of persons with asthma. Median pharmacy costs were $472, median medical costs were $483, and median total health care costs were $1199 for this population. CONCLUSIONS: Asthma appears to affect a significant number of enrollees within this MCO, with persons less than 18 years of age representing almost 29% of the treated patients. Health care costs in persons with asthma appears to be substantial.