Annual Costs of Care Increase With Severity of Uncontrolled Asthma

Annual health care costs increased alongside the severity of uncontrolled asthma events, indicating a relationship between severe, persistent asthma and subsequent health care spending. Researchers published their findings in the Journal of Managed Care and Specialty Pharmacy.

“The majority of both the economic and humanistic burden of asthma can be attributed to a subset of patients with severe uncontrolled disease,” said Joseph Tkacz, senior research director, health economics and outcomes research, Inovalon, and coauthors. “However, costs for severe uncontrolled asthma patients in the United States are not well described.”

For the study, investigators used administrative claims data from 2015 to 2020 across a variety of payer types, including Medicare Advantage, Managed Medicaid, and commercial insurance.

Included were patients who still had severe, persistent asthma in the 12 months following initial evidence of severe asthma. Patients were at least 12 years of age and had no other respiratory diseases or biologic treatment 1 year before and after the index period.

Researchers studied the costs incurred by 84,384 patients. Of these, 42,192 had uncontrolled disease and were matched 1:1 to patients with controlled asthma to allow for comparison.

“Standardized Medicare allowed payment amounts were applied to each type of service based on published Medicare rates to account for differences across plan types and geographic regions,” Tkacz and coinvestigators said.

As the severity of index events indicating uncontrolled disease increased, so did mean and median all-cause annual health care costs, researchers said. Stratified by service and treatment types, costs were as follows for those with severe, persistent asthma.

• 2 outpatient visits with systemic corticosteroid treatment (SCS)—mean $16,311 and median $8918 (SD $29,610; n=23,088)
• 1 emergency room visit and 1 outpatient visit with SCS—mean $21,234 and median $12,446 (SD $44,297; n=6569)
• 2 emergency room visits with SCS—mean $28,344 and median $16,631 (SD $43,657; n=5458)
• 1 hospitalization—mean $48,194 and median $31,158 (SD $72,672; n=7077)

Patients who did not experience an event indicating uncontrolled disease had the lowest costs, with a mean of $15,797 and median of $7530 (SD $28,005; n=42,192).

Data also showed prescription drug costs comprised a significant portion (19% to 37%) of median total spending across patient groups, with a range of $2457 to $4432.

“There is a clear relationship between events indicating uncontrolled disease and subsequent health care expenditure,” researchers concluded. “Improved management of severe uncontrolled asthma to prevent events indicating uncontrolled disease may reduce costs of care.”

Reference:
Tkacz J, Burnette A, Chung Y, et al. Costs of care among severe, persistent asthma patients following uncontrolled status in the US. J Manag Care Spec Pharm. 2022;28(10-a suppl):S1-S137. doi:10.18553/jmcp.2022.28.10-a.s1