Jan 152018

by Salynn Boyles, Contributing Writer, MedPage Today 

Asthma costs the U.S. economy more than $80 billion a year in medical expenditures, missed school and work days, and deaths, according to CDC researchers.

The condition is responsible for 8.7 million lost workdays and 5.2 million lost school-days annually, at an estimated cost of around $3 billion, reported Tursynbek Nurmagambetov, PhD, and colleagues from the CDC's National Center for Environmental Health in Annals of the American Thoracic Society.

They noted that their analysis probably underestimated the total cost of asthma to the U.S. economy because it did not include people who did not receive treatment for their asthma.

"People were included in our study if they had a least one visit to a medical provider or prescription medication for asthma during the year," Nurmagambetov told MedPage Today.

Approximately 40 million Americans, or 13% of the U.S. population, have a lifetime history of asthma and 26 million (8% of the population) currently have asthma, according to recent National Health Interview Survey data.

In their newly published analysis, the researchers used 2008-2013 data from the government's Medical Expenditure Panel Survey, a large-scale, nationally-representative survey of families and individuals, their medical providers and employers in the U.S.

Annual costs associated with asthma were estimated to be $81.9 billion -- around $25 billion more than a previous estimate of $56 billion annually made on the basis of 2002-2007 Medical Expenditure Panel Survey data.

For the main analysis, they applied two-part regression models to estimate asthma-related annual per-person incremental medical costs and negative binomial models to estimate absenteeism associated with asthma.

Their pooled sample included 213,994 people, including 10,237 people with treated asthma (prevalence 4.8%).

Among the main findings:

  • Roughly 15.4 million people in the U.S. are treated for asthma annually
  • The annual-per-person medical cost of asthma was estimated to be $3,266, including $1,830 for prescription medications, $640 for medical office visits, $176 for hospital outpatient visits and $105 for emergency room care
  • Deaths related to asthma average 3,168 annually, for a yearly cost of $29 billion
  • Children with asthma missed 2.3 additional school days annually compared to children without asthma, at a per-child cost of $207, and adults with asthma lost, on average, 1.8 days of work due to their illness

Having no health insurance was associated with significantly lower per person total medical expenditures, suggesting that these people paid for their asthma care out-of-pocket and/or had less medical care related to their asthma than the population average, Nurmagambetov said.

Blacks and Hispanics had lower medical costs for asthma than the population as a whole.

"Multiple studies demonstrated that these groups have consistently higher rates of hospitalizations and ER visits associated with asthma, but lower rates of asthma prescription medication and outpatient visits," the researchers wrote.

"This may explain their lower total medical cost of asthma, since prescription medications and outpatient visits are the two largest contributors to total medical care costs. Not having health insurance or high out-of-pocket costs for insured persons may preclude purchasing asthma medications, particularly long-acting anti-inflammatory asthma drugs, or seeking regular outpatient care."

The study did not include nonmedical costs associated with asthma, including transportation expenses, time lost waiting for appointments, and diminished productivity associated with asthma symptoms while at work or school.

"These findings highlight the critical need to support and further strengthen asthma control strategies through increased provision of guidelines-based care, improvements in self-management, and reduction of environmental asthma triggers in order to reduce ER visits, hospitalizations, absenteeism, and mortality," the researchers concluded.

Nurmagambetov told MedPage Today that the cost of asthma is one of the most important measures of the burden of the disease.

"It is important to understand and appreciate the economic cost of asthma," he said.

From MedPage Today.

Source: Annals ATS

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Annual Asthma-Related Expenditures in U.S. Exceed $80 Billion