Asthma costs and social impact

Carlos Nunes, Ana Margarida Pereira, Mário Morais-Almeida, Carlos Nunes, Ana Margarida Pereira, Mário Morais-Almeida

Abstract

In recent decades, both asthma prevalence and incidence have been increasing worldwide, not only due to the genetic background, but mainly because of the effect of a wide number of environmental and lifestyle risk factors. In many countries noncommunicable diseases, like asthma, are not yet considered a healthcare priority. This review will analyze and discuss disparities in asthma management in several countries and regions, such as access to healthcare human resources and medications, due to limited financial capacity to develop strategies to control and prevent this chronic disease. This review tries to explore the social and economic burden of asthma impact on society. Although asthma is generally accepted as a costly illness, the total costs to society (direct, indirect and intangible asthma costs) are difficult to estimate, mainly due to different disease definitions and characterizations but also to the use of different methodologies to assess the asthma socio-economic impact in different societies. The asthma costs are very variables from country to country, however we can estimate that a mean cost per patient per year, including all asthmatics (intermittent, mild, moderate and severe asthma) in Europe is $USD 1,900, which seems lower than USA, estimated mean $USD 3,100.

Keywords: Asthma; Burden; Control; Costs; Morbidity; Mortality; Socio-economic.

Figures

Fig. 1
Fig. 1
Annual cost of asthma per patient in Europe
Fig. 2
Fig. 2
Total asthmatics in Europe by severity
Fig. 3
Fig. 3
Asthma total cost by severity in Europe
Fig. 4
Fig. 4
Mortality death rate and DALY rate per 100.000 inhabitants, age- standardized

References

    1. Global Initiative for Asthma (GINA): Global strategy for asthma management and prevention. Update 2014 and Online Appendix. Available at . Accessed 12 Nov 2014.
    1. Braman SS. The global burden of asthma. Chest. 2006;130(1 Suppl):4–12. doi: 10.1378/chest.130.1_suppl.4S.
    1. Winer RA, Qin X, Harrington T, Moorman J, Zahran H. Asthma incidence among children and adults: findings from the behavioral risk factor surveillance system asthma call-back survey—United States, 2006–2008. J Asthma. 2012;49:16–22. doi: 10.3109/02770903.2011.637594.
    1. National Health Interview Survey (NHIS) 2012. Data, Statistics, and Surveillance. Available at . Accessed 22 Oct 2014.
    1. Masoli M, Fabian D, Holt S, Beasley R, Global initiative for asthma (GINA) Program The global burden of asthma: executive summary of the GINA dissemination committee report. Allergy. 2004;59:469–478. doi: 10.1111/j.1398-9995.2004.00526.x.
    1. Sá-Sousa A, Jacinto T, Azevedo LF, Morais-Almeida M, Robalo-Cordeiro C, Bugalho-Almeida A, Bousquet J, Fonseca JA. Operational definitions of asthma in recent epidemiological studies are inconsistent. Clin Transl Allergy. 2014;4:24. doi: 10.1186/2045-7022-4-24.
    1. Sá-Sousa A, Morais-Almeida M, Azevedo LF, Carvalho R, Jacinto T, Todo-Bom A, Loureiro C, Bugalho-Almeida A, Bousquet J, Fonseca JA. Prevalence of asthma in Portugal - The Portuguese National Asthma Survey. Clin Transl Allergy. 2012;2:15. doi: 10.1186/2045-7022-2-15.
    1. National Health and Nutrition Examination Survey 2005–2006. .
    1. Braman SS. Asthma in the elderly. Clin Geriatr Med. 2003;19:57–75. doi: 10.1016/S0749-0690(02)00052-6.
    1. Lee YH, Yoon SJ, Kim EJ, Kim YA, Seo HY, Oh IH. Economic burden of asthma in Korea. Allergy Asthma Proc. 2011;32:35–40. doi: 10.2500/aap.2011.32.3479.
    1. Asher I, Pearce N. Global burden of asthma among children. Int J Tuberc Lung Dis. 2014;18:1269–1278. doi: 10.5588/ijtld.14.0170.
    1. Bousquet J, Bousquet PJ, Godard P, Daures JP. The public health implications of asthma. Bull World Health Organ. 2005;83:548–554.
    1. Sullivan PW, Slejko JF, Ghushchyan VH, Sucher B, Globe DR, Lin SL, Globe G. The relationship between asthma, asthma control and economic outcomes in the United States. J Asthma. 2014;51:769–778. doi: 10.3109/02770903.2014.906607.
    1. Accordini S, Corsico AG, Braggion M, Gerbase MW, Gislason D, Gulsvik A, Heinrich J, Janson C, Jarvis D, Jõgi R, Pin I, Schoefer Y, Bugiani M, Cazzoletti L, Cerveri I, Marcon A, de Marco R. The cost of persistent asthma in Europe: an international population-based study in adults. Int Arch Allergy Immunol. 2013;160:93–101. doi: 10.1159/000338998.
    1. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC) Eur Respir J. 1998;12:315–335. doi: 10.1183/09031936.98.12020315.
    1. World Health Organization. WHO factsheet 206: bronchial asthma. Available at: . Accessed 23 Oct 2014.
    1. Burney P, Jarvis D, Perez-Padilla R. The global burden of chronic respiratory disease in adults. Int J Tuberc Lung Dis. 2015;19:10–20. doi: 10.5588/ijtld.14.0446.
    1. Global Atlas of Asthma. Cezmi A. Akdis, Ioana Agache. Zurich, Switzerland. Edited by the European Academy of Allergy and Clinical Immunology (EAACI). 2014.
    1. Rabe KF, Adachi M, Lai CK, Soriano JB, Vermeire PA, Weiss KB, Weiss ST. Worldwide severity and control asthma in children and adults. The global Asthma and Insights and Reality surveys. J Allergy Clin Immunol. 2004;114:40–47. doi: 10.1016/j.jaci.2004.04.042.
    1. Lai CK, De Guia TS, Kim YY, Kuo SH, Mukhopadhyay A, Soriano JB, Trung PL, Zhong NS, Zainudin N, Zainudin BM, Asthma Insights and Reality in Asia-Pacific Steering Committee Asthma control in the Asia-Pacific region: the Asthma Insights and Reality in Asia-Pacific Study. J Allergy Clin Immunol. 2003;111:263–268. doi: 10.1067/mai.2003.30.
    1. Cisternas MG, Blanc PD, Yen IH, Katz PP, Earnest G, Eisner MD, Shiboski S, Yelin EH. A comprehensive study of the direct and indirect costs of adult asthma. J Allergy Clin Immunol. 2003;111:1212–1218. doi: 10.1067/mai.2003.1449.
    1. Bahadori K, Doyle-Waters MM, Marra C, Lynd L, Alasaly K, Swiston J, FitzGerald JM. Economic burden of asthma: a systematic review. BMC Pulm Med. 2009;9:24. doi: 10.1186/1471-2466-9-24.
    1. National Hospital Ambulatory Medical Care Survey (NHAMCS), available at . Accessed 25 Oct 2014.
    1. . Accessed 15 Dec 2014.
    1. Gergen PJ. Understanding the economic burden of asthma. J Allergy Clin Immunol. 2001;107(5 Suppl):445–448. doi: 10.1067/mai.2001.114992.
    1. Gendo K, Sullivan SD, Lozano P, Finkelstein JA, Fuhlbrigge A, Weiss KB. Resource costs for asthma-related care among pediatric patients in managed care. Ann Allergy Asthma Immunol. 2003;91:251–257. doi: 10.1016/S1081-1206(10)63526-0.
    1. Martínez-Moragón E, Serra-Batllés J, De Diego A, Palop M, Casan P, Rubio-Terrés C, Concepción Pellicer on behalf of the Asthma Cost Study Group Economic Cost of Treating the Patient With Asthma in Spain: The Asma Cost Study. Arch Bronconeumol. 2009;45:481–486. doi: 10.1016/j.arbres.2009.04.006.
    1. Kim CY, Park HW, Ko SK, Chang SI, Moon HB, Kim YY, Cho SH. The financial burden of asthma: a nationwide comprehensive survey conducted in the republic of Korea. Allergy, Asthma Immunol Res. 2011;3:34–38. doi: 10.4168/aair.2011.3.1.34.
    1. Bedouch P, Sadatsafavi M, Marra CA, FitzGerald JM, Lynd LD. Trends in asthma-related direct medical costs from 2002 to 2007 in British Columbia, Canada: a population based-cohort study. PLoS ONE. 2012;7:e50949. doi: 10.1371/journal.pone.0050949.
    1. Ismaila AS, Sayani AP, Marin M, Su Z. Clinical, economic, and humanistic burden of asthma in Canada: a systematic review. BMC Pulm Med. 2013;13:70. doi: 10.1186/1471-2466-13-70.
    1. Aumann I, Prenzler A, Welte T, Gillissen A. Epidemiology and costs of asthma in Germany - a systematic literature review. Pneumologie. 2014;68:557–567. doi: 10.1055/s-0034-1377225.
    1. Rank MA, Liesinger JT, Ziegenfuss JY, Branda ME, Lim KG, Yawn BP, Li JT, Shah ND. Asthma expenditures in the United States comparing 2004 to 2006 and 1996 to 1998. Am J Manag Care. 2012;18:499–504.
    1. European Lung White Book. Brussels, Belgium: European Respiratory Society and the European Lung Foundation, 2003.
    1. Borderias Clau L, Zabaleta Murguionda M, Riesco Miranda JA, Pellicer Ciscar C, Hernandez Hernandez JR, Carrillo Diaz T, Lumbreras GG. Cost and management of asthma exacerbations in Spanish hospitals (COAX study in hospital services) Arch Bronconeumol. 2005;41:313–321.
    1. Pirina P, Carrozzi L, Dallari R, De Togni A, de Marco R. Poor control increases the economic cost of asthma. A multicentre population-based study. Int Arch Allergy Immunol. 2006;141:189–198. doi: 10.1159/000094898.
    1. Antonicelli L, Bucca C, Neri M, De Benedetto F, Sabbatani P, Bonifazi F, Eichler HG, Zhang Q, Yin DD. Asthma severity and medical resource utilisation. Eur Respir J. 2004;23:723–729. doi: 10.1183/09031936.04.00004904.
    1. Kiivet RA, Kaur I, Lang A, Aaviksoo A, Nirk L. Costs of asthma treatment in Estonia. Eur J Public Health. 2001;11:89–92. doi: 10.1093/eurpub/11.1.89.
    1. Beyhun NE, Cilingiroglu N, Sekerel BE. The cost of childhood asthma and its determinants in Ankara, Turkey. Turk J Pediatr. 2007;49:179–188.
    1. Neville RG, Hoskins G, Smith B, McCowan C. The economic and human costs of asthma in Scotland. Prim Care Respir J. 2003;12:115–119. doi: 10.1038/pcrj.2003.64.
    1. World Health Organization. WHO consultation on the development of a comprehensive approach for the prevention and control of chronic respiratory diseases. 2001 Geneva. Available at: . Accessed 23 Oct 2014.
    1. Nunes C, Ladeira S. Asthma, from childhood to adulthood, longitudinal prospective study of a cohort of asthmatics during a period of 20 year. Rev Port Imunol. 2004;3:209–223.
    1. Godard P, Chanez P, Siraudin L, Nicoloyannis N, Duru G. Costs of asthma are correlated with severity: a 1-yr prospective study. Eur Respir J. 2002;19:61–67. doi: 10.1183/09031936.02.00232001.
    1. Plaza V, Serra-Batlles J, Ferrer M, Morejon E. Quality of life and economic features in elderly asthmatics. Respiration. 2000;67:65–70. doi: 10.1159/000029465.
    1. Stock S, Redaelli M, Luengen M, Wendland G, Civello D, Lauterbach KW. Asthma: prevalence and cost of illness. Eur Respir J. 2005;25:47–53. doi: 10.1183/09031936.04.00116203.
    1. Barnett SB, Nurmagambetov TA. Costs of asthma in the United States: 2002-2007. J Allergy Clin Immunol. 2011;127:145–152. doi: 10.1016/j.jaci.2010.10.020.
    1. Jang J, Gary Chan KC, Huang H, Sullivan SD. Trends in cost and outcomes among adult and pediatric patients with asthma: 2000-2009. Ann Allergy Asthma Immunol. 2013;111:516–522. doi: 10.1016/j.anai.2013.09.007.
    1. Meurer JR, Kuhn EM, George V, Yauck JS, Layde PM. Charges for childhood asthma by hospital characteristics. Pediatrics. 1998;102:E70. doi: 10.1542/peds.102.6.e70.
    1. Huang ZJ, LaFleur BJ, Chamberlain JM, Guagliardo MF, Joseph JG. Inpatient childhood asthma treatment: relationship of hospital characteristics to length of stay and cost: analyses of New York State discharge data, 1995. Arch Pediatr Adolesc Med. 2002;156:67–72. doi: 10.1001/archpedi.156.1.67.
    1. Serra-Batlles J, Plaza V, Morejon E, Comella A, Brugues J. Costs of asthma according to the degree of severity. Eur Respir J. 1998;12:1322–6. doi: 10.1183/09031936.98.12061322.
    1. Hoskins G, McCowan C, Neville RG, Thomas GE, Smith B, Silverman S. Risk factors and costs associated with an asthma attack. Thorax. 2000;55:19–24. doi: 10.1136/thorax.55.1.19.
    1. Global Asthma Report 2014 available at . Accessed 12 Nov 2014.
    1. Leon DA. Trends in European life expectancy: a salutary view. Int J Epidemiol. 2011;40:271–277. doi: 10.1093/ije/dyr061.
    1. Bousquet J, Dahl R, Khaltaev N. Global alliance against chronic respiratory diseases. Eur Respir J. 2007;29:233–239. doi: 10.1183/09031936.00138606.
    1. Haahtela T, Tuomisto LE, Pietinalho A, Klaukka T, Erhola M, Kaila M, Nieminen MM, Kontula E, Laitinen LA. A 10 year asthma programme in Finland: major change for the better. Thorax. 2006;61:663–670. doi: 10.1136/thx.2005.055699.
    1. Mukherjee M, Gupta R, Farr A, Heaven M, Stoddart A, Nwaru BI, Fitzsimmons D, Chamberlain G, Bandyopadhyay A, Fischbacher C, Dibben C, Shields M, Phillips C, Strachan D, Davies G, McKinstry B, Sheikh A, Burden and True Cost of Asthma in the UK Research Team Estimating the incidence, prevalence and true cost of asthma in the UK: secondary analysis of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales - a study protocol. BMJ Open. 2014;4:e006647. doi: 10.1136/bmjopen-2014-006647.

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