The Environmental, Healthcare, and Societal Impact of Asthma Pathway in the UK: A Cost-of-Illness Study

OBJECTIVES: Although previous research has reported the economic or environmental impact of single aspects of asthma management (e.g., environmental impact of inhalers, healthcare impact), there remains a gap in the understanding of the overall impact of the entire asthma pathway. The objective of this study was to holistically assess the environmental, healthcare, and societal impact along the asthma pathway in the UK, from diagnosis to treatment.

METHODS: A comprehensive cost-of-illness (COI) model was used to map, quantify, and express in monetary value the environmental, healthcare, and wider societal impact associated with asthma in the UK. The model captured the impact of the asthma pathway on NHS costs, greenhouse Gas (GHG) emissions, patient travel costs, health-related quality of life (HRQoL), and productivity loss. Model inputs were informed from targeted literature review and supported by clinical expert opinion. The analysis expressed results in net present monetary value (NPMV) over the period 2022-2031, with projections to future years made based on historical data.

RESULTS: The NMPV of the total impact of asthma in the UK was estimated to be £47bn between 2022-2031, with the majority (77%) attributed to the impact of loss of asthma control (i.e., worsening or exacerbation of symptoms) on HRQoL and productivity losses. In 2022, loss of asthma control was estimated to lead to a 22% increase in NHS costs, and 65% in GHG emissions due to higher use of secondary care and reliever inhalers. In 2022, costs from productivity losses were £2.9bn, while costs related to HRQoL and years lost due to premature death were estimated at £1.1bn.

CONCLUSIONS: Asthma control significantly impacts the economy, environment, and patient HRQoL. Hence, policy making should place patients and their disease control at central point and should consider carefully and holistically the impact of the asthma pathway.