PS 1-6 TEN-YEAR TRENDS IN DIRECT COSTS OF ASTHMA: A POPULATION-BASED STUDY

Sunday, October 23, 2016
Bayshore Ballroom ABC, Lobby Level (Westin Bayshore Vancouver)
Poster Board # PS 1-6

Hamid Tavakoli, MD, MSc, University of British Colombia, Department of Medicine,Division of Respiratory Medicine, Vancouver, BC, Canada, J Mark FitzGerald, MD, FACP., UBC , Department of Medicine,The Lung Centre, Vancouver, BC, Canada, Wenjia Chen, PhD Candidate, University of British Columbia,Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada, Larry D. Lynd, PhD, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada, Tetyana Kendzerska, MD, MSc, PhD, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada, Shawn Aaron, MD, FRCPC, University of Ottawa, Division Director- Respirology, Ottawa, ON, Canada, Andrea Gershon, MD, M.Sc., Sunnybrook Health Sciences Centre, Toronto, ON, Canada, Carlo Marra, PhD, Memorial University, St. John's, NF, Canada and Mohsen Sadatsafavi, MD, PhD, UBC, Department of Medicine, Vancouver, BC, Canada

Purpose: Our objective was to estimate the excess costs of asthma and its trend in British Columbia, Canada, from 2002 to 2011.

Method:

A retrospective cohort of individuals aged 5 to 55 years was constructed from the provincial administrative health databases, consisting of patients with physician-diagnosed asthma and a propensity-score-matched comparison sample from the general population. Total direct medical costs were calculated as the sum of hospitalisations, outpatient visits, and medication costs, adjusted to 2012 Canadian dollars ($). Excess costs were defined as the difference in costs between the asthma and comparison groups.

Result: 341,457 individuals (mean age at entry 27.3, 54.1% female) were equally divided into the asthma and comparison groups. Excess costs in patients with asthma were $1,028.0 (95%CI $982.7-$1073.4) per patient-year. Medications contributed to the greatest share of excess costs ($471.7/patient-year), whereas hospitalisation and outpatient costs were, respectively, $272.2/patient-year and $284.1/patient-year. Only $192.9/patient-year were attributable to asthma itself. There was a 2.9%/year increase in excess costs (P<0.001), a combination of asthma-attributable costs declining by 0.8%/year while non-asthma excess costs increasing by 3.8%/year. The most dramatic trend was observed in asthma-related outpatient costs, which decreased by %6.6/year.

Figure 1 presents the breakdown of excess costs of medications by major drug classes.  Single-inhaler combination of inhaled corticosteroids (ICS) and long-acting beta agonists (LABA) demonstrated the greatest increase in annual per-patient costs overall, by 6.5%/year (95%CI 6.4%‒6.6%; P<0.001). 

Conclusion:

A significant share of excess costs in asthma is not attributable to the disease itself. The pattern of costs changed significantly during the study period. The burden of comorbid conditions should be considered in developing evidence-based policies for management of patients with asthma.

Funding: This study was funded by the Canadian Respiratory Research Network (CRRN)

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