MAPPING THE BURDEN AND MANAGEMENT OF ASTHMA, SEVERE ASTHMA, AND EOSINOPHILIC ASTHMA ACROSS ONTARIO, CANADA
Author(s)
Ellie Joung, MPH1, Mackenzie A. Hamilton, MPH1, Charles St Pierre, MSc, PhD1, Jane Ran, PharmD1, Ross Ormsby, PhD1, Amyn Sayani, MSc, PhD1, James Michael Ramsahai, MD, PhD, FRCPC2.
1AstraZeneca Canada, Mississauga, ON, Canada, 2Division of Respirology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
1AstraZeneca Canada, Mississauga, ON, Canada, 2Division of Respirology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
OBJECTIVES: To characterize regional variations in the epidemiology, healthcare resource utilization (HCRU), and treatment of asthma, severe asthma (SA), and eosinophilic asthma (EA) to improve access to healthcare resources and patient outcomes. Asthma is associated with a significant burden of illness, HCRU, and healthcare costs.
METHODS: A retrospective observational cohort study using health administrative databases in Ontario from 2018-2023. Patients ≥12 years old with asthma were identified from hospitalization and claims data using ICD diagnostic codes and validated case definitions. Asthma patients aged 65≥ were identified with SA according to Canadian Thoracic Society guidelines, as those with dispenses of a high dose inhaled corticosteroid and either a long-acting beta 2-agonist or oral/systemic corticosteroids within 365 days of each other. Asthma patients with EA were defined as those with the highest recorded blood eosinophil count exceeding 300 cells/uL. Prevalence, incidence, treatment patterns, and HCRU were evaluated per Public Health Unit (PHU) across Ontario.
RESULTS: From 2018 to 2023, prevalence rate of asthma and SA decreased from 11.2% to 10.9% and 1.9% to 1.6%, respectively, while EA increased from 5.7% to 6.4%. Regional variations of key outcomes in these populations persisted from 2018 to 2023. In 2023, the range of standardized rates per 1000 person-years for respiratory-specific hospitalizations across PHUs was 20.9 (19.2-40.1), 194.0 (125.8-319.8), and 28.7 (25.8-54.5) for asthma, SA and EA, respectively. Variation between PHUs were similarly seen in dual maintenance therapy usage of ICS and LABA in SA patients aged 65≥ with a range of 13.5% to 19.0 in 2023.
CONCLUSIONS: To our knowledge, this is the first study to demonstrate the regional variation of burden and care of EA across Ontario. Our findings could help improve patient outcomes, health equity, and health system performance through root cause analyses and region-specific interventions for asthma and its sub-types.
METHODS: A retrospective observational cohort study using health administrative databases in Ontario from 2018-2023. Patients ≥12 years old with asthma were identified from hospitalization and claims data using ICD diagnostic codes and validated case definitions. Asthma patients aged 65≥ were identified with SA according to Canadian Thoracic Society guidelines, as those with dispenses of a high dose inhaled corticosteroid and either a long-acting beta 2-agonist or oral/systemic corticosteroids within 365 days of each other. Asthma patients with EA were defined as those with the highest recorded blood eosinophil count exceeding 300 cells/uL. Prevalence, incidence, treatment patterns, and HCRU were evaluated per Public Health Unit (PHU) across Ontario.
RESULTS: From 2018 to 2023, prevalence rate of asthma and SA decreased from 11.2% to 10.9% and 1.9% to 1.6%, respectively, while EA increased from 5.7% to 6.4%. Regional variations of key outcomes in these populations persisted from 2018 to 2023. In 2023, the range of standardized rates per 1000 person-years for respiratory-specific hospitalizations across PHUs was 20.9 (19.2-40.1), 194.0 (125.8-319.8), and 28.7 (25.8-54.5) for asthma, SA and EA, respectively. Variation between PHUs were similarly seen in dual maintenance therapy usage of ICS and LABA in SA patients aged 65≥ with a range of 13.5% to 19.0 in 2023.
CONCLUSIONS: To our knowledge, this is the first study to demonstrate the regional variation of burden and care of EA across Ontario. Our findings could help improve patient outcomes, health equity, and health system performance through root cause analyses and region-specific interventions for asthma and its sub-types.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH216
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)