The Projected Economic and Health Burden of Uncontrolled Asthma in the United States

Abstract

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AAP Policy SupplementsSupplements Publish Supplement MultimediaVideo Abstracts Pediatrics On Call Podcast Subscribe Alerts Careers We will not be accepting article comments until November 8, 2021, while our site undergoes major changes. We apologize for the inconvenience. For questions, contact the editorial office. Asthma The Projected Economic and Health Burden of Uncontrolled Asthma in the United States Jennilee M. Eppley and Todd A. Mahr Pediatrics December 2020, 146 (Supplement 4) S370; DOI: https://doi.org/10.1542/peds.2020-023861AAAA Jennilee M. Eppley La Crosse, WisconsinFind this author on Google ScholarFind this author on PubMedSearch for this author on this siteTodd A. Mahr La Crosse, WisconsinFind this author on Google ScholarFind this author on PubMedSearch for this author on this site ArticleInfo & MetricsComments Download PDF M Yaghoubi, A Adibi, A Safari, JM FitzGerald, M Sadatsafavi. Am J Respir Crit Care Med. 2019;200(9):1102–1112PURPOSE OF THE STUDY:A significant proportion of asthma patients remain inadequately controlled despite effective treatments available. The purpose of this study was to acknowledge the current economic and health burden of uncontrolled asthma in the United States as well as project future potentially preventable economic and health burden associated with uncontrolled asthma over the next 20 years.STUDY POPULATION:This study included adults and adolescents aged ≥15 years in the United States. People with asthma were separated into controlled versus uncontrolled asthma using their Asthma Control Test (ACT) score.METHODS:To project burden over a 20-year timespan (2019–2038), researchers used a probabilistic model taking into account state-specific estimates of population growth, aging, asthma prevalence, and asthma control levels. Primary projections were made at a national level with secondary results done at a state level. Total direct costs, indirect costs and quality-adjusted life years (QALYs) due to uncontrolled asthma were included in the projections.RESULTS:The total 20-year direct cost associated with uncontrolled asthma is estimated to be $300.6 billion (95% CI, $190.1 billion–411.1 billion) nationwide. When direct and indirect costs are combined, the total 20-year economic burden is projected to be $963.5 billion (95% CI, $664.1 billion–1262.9 billion). Quality-adjusted life years lost due to uncontrolled asthma will be 15.46 million (95% CI, 12.77 million–18.14 million). An additional analysis that separated uncontrolled asthma into not well controlled and very poorly controlled showed that the very poorly controlled group is responsible for 76% of direct costs, 83% of indirect costs, and 77% of QALYs lost. At the state level, the average 20-year per capita costs due to uncontrolled asthma ranged from $2209 to $6312.CONCLUSIONS:The economic and health burden of asthma is significant and will continue to increase without intervention. A substantial proportion of this burden is preventable. The development and implementation of new asthma control strategies and improved adherence has the potential to greatly reduce costs and improve quality of life.REVIEWER COMMENTS:The public health impact of asthma in the United States is substantial. Despite a wide range of effective asthma treatments available, a large proportion of asthmatic individuals continue to remain inadequately controlled. People with uncontrolled asthma generally have more emergent care visits, hospitalizations, and missed work or school days, consistent with the direct and indirect costs noted in this study. Furthermore, those with uncontrolled asthma commonly have reduced quality of life. Previous studies examining the economic burden of asthma have generally looked at the overall cost of asthma, regardless of level of control, compared with not having asthma. This is important information when examining the comprehensive estimated economic burden of asthma. This study takes the next step by examining the current and projected cost within asthma groups (controlled versus uncontrolled), providing a more in-depth look to be considered by policymakers and asthma management programs. Having a thorough understanding of the burden of this disease can help fuel further searching for interventions and programs aimed at achieving asthma control.Copyright © 2020 by the American Academy of Pediatrics PreviousNext Back to top Advertising Disclaimer » In this issue Pediatrics Vol. 146, Issue Supplement 4 1 Dec 2020 Table of ContentsIndex by author View this article with LENS PreviousNext Email Article Thank you for your interest in spreading the word on American Academy of Pediatrics.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. 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Mahr Pediatrics Dec 2020, 146 (Supplement 4) S370; DOI: 10.1542/peds.2020-023861AAAA Citation Manager Formats BibTeXBookendsEasyBibEndNote (tagged)EndNote 8 (xml)MedlarsMendeleyPapersRefWorks TaggedRef ManagerRISZotero Share The Projected Economic and Health Burden of Uncontrolled Asthma in the United States Jennilee M. Eppley, Todd A. Mahr Pediatrics Dec 2020, 146 (Supplement 4) S370; DOI: 10.1542/peds.2020-023861AAAA Share This Article: Copy Print Download PDF Insight Alerts Table of Contents Jump to section ArticlePURPOSE OF THE STUDY:STUDY POPULATION:METHODS:RESULTS:CONCLUSIONS:REVIEWER COMMENTS:Info & MetricsComments Related ArticlesNo related articles found.Google Scholar Cited By...No citing articles found.Google Scholar More in this TOC SectionAsthma Prevalence of Continuous Pulse Oximetry Monitoring in Hospitalized Children With Bronchiolitis Not Requiring Supplemental Oxygen Lung Computational Models and the Role of the Small Airways in Asthma Increased Capsaicin Sensitivity in Patients With Severe Asthma Is Associated With Worse Clinical Outcome Show more Asthma Diagnosis and Management Telehealth Delivery of Adherence and Medication Management System Improves Outcomes in Inner-City Children With Asthma Association Between Fungal Spore Exposure in Inner-City Schools and Asthma Morbidity Show more Diagnosis and Management Similar Articles Journal Info Editorial Board Editorial Policies Overview Licensing Information Authors/Reviewers Author Guidelines Submit My Manuscript Open Access Reviewer Guidelines Librarians Institutional Subscriptions Usage Stats Support Contact Us Subscribe Resources Media Kit About International Access Terms of Use Privacy Statement FAQ AAP.org shopAAP Follow American Academy of Pediatrics on Instagram Visit American Academy of Pediatrics on Facebook Follow American Academy of Pediatrics on Twitter Follow American Academy of Pediatrics on Youtube RSS © 2021 American Academy of Pediatrics