Modeling the Healthcare Burden of Oral Corticosteroid Use in Mexico
Author(s)
Samir Sattar, BS1, Rodrigo Abisai Rubio Ponce, Bachelor of Science2, Ivonne Pardo Gutierrez, BS, MSc3.
1AstraZeneca, Stapleford, United Kingdom, 2AstraZeneca, Mexico, Mexico, 3AztraZeneca, Mexico, Mexico.
1AstraZeneca, Stapleford, United Kingdom, 2AstraZeneca, Mexico, Mexico, 3AztraZeneca, Mexico, Mexico.
OBJECTIVES: To quantify both the patient impact and economic burden of oral corticosteroid (OCS)-related adverse events (AEs) as healthcare system costs in patients with severe asthma in Mexico.
METHODS: A cost-offset model with a Markov structure was developed to compare an OCS intervention arm versus a no-OCS control arm over a lifetime horizon with 4-week cycles. Seven health states were modeled: (1) type 2 diabetes (DMT2), (2) osteoporosis, (3) cardiovascular events (ECV), (4) DMT2 + osteoporosis, (5) osteoporosis + ECV, (6) ECV + DMT2, and (7) ECV + DMT2 + osteoporosis. Transitions to death or additional clinical events impacting morbidity and mortality were included. The model assumed an OCS dose of 5.5 mg/day of prednisone.
RESULTS: OCS use in severe asthma led to significantly higher per-patient costs. In a modeled cohort of 93,240 patients, the per-patient cost was estimated at USD 10,481, resulting in a total incremental cost of USD 977,242,937 to the national health system. The most impactful OCS-related AEs in terms of cost and health burden were renal impairment, adrenal insufficiency, and bruising. Renal and adrenal complications accounted for the highest societal costs, hospital bed days, and lost workdays over a lifetime.
CONCLUSIONS: OCS use in severe asthma imposes a significant clinical and economic burden, mainly driven by renal and adrenal complications. These findings support the need for OCS-sparing strategies in Mexico, in line with global recommendations for better patient outcomes and resource optimization.
METHODS: A cost-offset model with a Markov structure was developed to compare an OCS intervention arm versus a no-OCS control arm over a lifetime horizon with 4-week cycles. Seven health states were modeled: (1) type 2 diabetes (DMT2), (2) osteoporosis, (3) cardiovascular events (ECV), (4) DMT2 + osteoporosis, (5) osteoporosis + ECV, (6) ECV + DMT2, and (7) ECV + DMT2 + osteoporosis. Transitions to death or additional clinical events impacting morbidity and mortality were included. The model assumed an OCS dose of 5.5 mg/day of prednisone.
RESULTS: OCS use in severe asthma led to significantly higher per-patient costs. In a modeled cohort of 93,240 patients, the per-patient cost was estimated at USD 10,481, resulting in a total incremental cost of USD 977,242,937 to the national health system. The most impactful OCS-related AEs in terms of cost and health burden were renal impairment, adrenal insufficiency, and bruising. Renal and adrenal complications accounted for the highest societal costs, hospital bed days, and lost workdays over a lifetime.
CONCLUSIONS: OCS use in severe asthma imposes a significant clinical and economic burden, mainly driven by renal and adrenal complications. These findings support the need for OCS-sparing strategies in Mexico, in line with global recommendations for better patient outcomes and resource optimization.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE589
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)