Uncontrolled asthma leads to out of control costs

SRxA’s Word on Health has often reported on the price of non-adherence to treatment . So, although we were shocked, we weren’t surprised to learn that poorly controlled asthma doubles costs and affects children’s performance in school.

According to a study just published in the Annals of Allergy, Asthma and Immunology  children with very poorly controlled asthma miss an average of 18 days from the classroom; whereas kids whose disease is better controlled, are absent for two days or less.

The investigators from National Jewish Hospital studied 628 children aged 6-12 with severe asthma. They looked at direct medical costs such as medications, unscheduled doctor visits, emergency department visits and hospital admissions as well as the indirect costs such as school days lost.

Patients were divided into three groups: very poorly controlled, not well controlled and well controlled. Costs were evaluated at the start of the study and then one and two years later.

The group, led by Stanley Szefler MD found that the costs for very poorly controlled patients were twice as high as those of the other groups at baseline. Very poorly controlled patients cost $7,846, compared with $3,526 for not-well controlled and $3,766 for well-controlled.

Two years later the costs for the very poorly controlled group had risen to $8,880 while costs for those with well-controlled asthma dropped to $1,861.  Indirect costs accounted for approximately half the total asthma costs for very poorly controlled asthma patients at each time point.

The authors concluded that very poorly controlled asthma is a major economic burden and improvement in asthma control and is associated with reducing cost.

SRxA together with our expert Allergy and Pulmonary Advisors  can help pharmaceutical companies promote better management strategies that may significantly reduce this burden of illness. For more information, contact us today.

Bad Breath? – Doctors speak doctor while Patients speak patient

While attending the ACAAI congress in Phoenix, SRxA’s Word on Health learned that despite the increasing availability of effective treatments, overall asthma care in the U.S. is suboptimal.

In a survey of almost 4,000 asthma patients, doctors and members of the general population, 71% of the asthma patients had disease that was either not well or very poorly controlled according to definitions established by current guidelines.

On the other hand, the majority of asthma patients said they thought their disease was well controlled, suggesting that many patients don’t understand the meaning of the term “adequate asthma control”.

The so-called Asthma Insight and Management study was a national survey of three populations, with responses from 2,500 asthma patients age 12 and older, 1,090 adults in the general population, and 309 health care providers.  It was conducted by SRxA Advisors, Michael Blaiss,  Eli Meltzer and colleagues, Drs Kevin Murphy, Robert Nathan and Stuart Stoloff

Among some of the more surprising results, researchers found:

  • 64% of asthma patients thought their disease was well controlled because they had two or more months between exacerbations.
  • 61% thought their asthma was well controlled because they had only been forced to go to the emergency room for asthma once in the previous year.
  • Only 6% agreed their disease was either not well or very poorly controlled.
  • Only 48% of patients reported that they followed the advice of their doctor.

Despite this, the disease burden is high.  63% of the patients said their asthma persisted throughout the year and 41% reported that the illness interfered with their life “some” or “a lot.”  Compared with the general population, Blaiss and colleagues found, asthma patients reported poorer general health, greater limitations on activity, and taking more than twice as many sick and disability days off work.

According to another SRxA Advisor, Dr. John Oppenheimer,  the study confirms what many clinicians have long suspected. He told us, “While there are many possible causes for suboptimal management, one of the problems is doctors speak doctor and patients speak patient.”

Both physicians and the manufacturers of asthma drugs need to make more of an effort to understand why asthma patients don’t use medications as directed  in order to help them improve both their health and quality of life.

What are your thoughts on this?  Word in Health is waiting to hear from you.