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Persistent asthma: disease control, resource utilisation and direct costs

¹ Pharmacoepidemiology Unit, EA643 and Poison Centre, ² Clinical Pharmacology Unit, EA643, Claude­Bernard University and ³ Respiratory Medicine, South Lyon Hospital Centre University Hospital, Lyon, France. ⁴ Merck & Co., Inc., Whitehouse Station, NJ, USA. ⁵ Pharmacoepidemiology Unit, McGill University, Montreal, Canada

CORRESPONDENCE: E. Van Ganse, Centre Antipoison, Centre de Pharmacovigilance, Pavillon N, Hôpital Edouard Herriot, Lyon, 69347, Cedex 03, France. Fax: 33 472666444. E-mail: eric.vanganse@chu­lyon.fr

Keywords: asthma, control, health economics, resource utilisation, severity, therapy

Received: December 12, 2001
Accepted April 4, 2002

The Pharmacoepidemiology Unit is part of the EA643 (Claude­Bernard University, Lyon, France) and of the Poison Centre (E. Herriot Hospital, Lyon, France). The study was supported by the Biomed grant Nr BMH4 CT965033 and by Merck & Co., Inc., Whitehouse Station, NJ, USA.

Despite evidence that adverse outcomes are less frequent when asthma management is optimised, the link between the level of control, disease severity and medical resource utilisation (MRU) is poorly documented. This relationship was investigated in a group of patients suffering from persistent asthma (Global Initiative for Asthma (GINA) 2) in France.

In 1998 a computerised family practice database was used to identify asthma patients aged 17–50 yrs. Information from the database was complemented by a patient survey to retrospectively assess the level of asthma control and hospital contacts. Costs of MRU over a 12­month study period were related to demographics, medical history, asthma control, and doses of inhaled corticosteroids prescribed during the prestudy period.

A review of the computerised medical database identified 1,038 adult patients with persistent asthma, who completed the survey questionnaire. Over a 12­month period, the mean cost of MRU was 549.8 E for well­controlled patients, 746.3 E per patient with moderate control, and 1,451.3 E per patient with poor control. Costs also increased significantly with age, access to free asthma care, comorbid conditions, asthma symptoms in the past year and whether inhaled corticosteroids had been prescribed before the study period.

In patients with persistent asthma, large differences were observed in the use of medical resources according to control and severity. Therefore, if patients appropriately use prescribed control therapy, their use of medical resources may be reduced.

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