OBJECTIVES : To identify the current literature regarding healthcare resource use and cost burden of asthma in the US.

METHODS : EMBASE® and MEDLINE® were systematically searched for 2015–2019 to identify English-language articles reporting the clinical and economic burden of asthma in the US. Two reviewers independently screened citations and extracted data.

RESULTS : Of 951 citations screened, 91 publications met the inclusion criteria. The total cost of asthma in 2013 (inflated to 2015; data from Medical Expenditure Panel Survey) was $81.9 billion including costs due to absenteeism ($50.3 billion), losses due to missed work/school days ($3 billion), and mortality ($29 billion). Between 2008 and 2013, the annual per-person incremental medical cost of asthma was $3,266 (Nurmagambetov 2018). For school-aged children (SAC), the total annual healthcare expenditures attributable to asthma in 2013 (inflated to 2015) was $5.92 billion (Sullivan 2017). The latest data are inflated to 2015 in studies; however, the medical inflation rates in the US between 2015 and 2020 do not drastically impact the costs reported for overall burden. During 2007–2013, SAC with asthma/their caregivers missed 1.54/1.16 times the number of school days/number of workdays to care than those without asthma (Sullivan 2018). Among all asthma emergency department visits recorded in the National Hospital Ambulatory Medical Care Survey during 2002–2012, 12.3% resulted in hospitalization and 1.0% resulted in critical care unit transfer (Caspard 2017). A study on subsequent hospital readmission rates where asthma was the primary diagnosis within 30 days following an original asthma admission through the years 2009–2013 found these to be 5.1%, 5.4%, 5.3%, 5.1% and 5.1%, respectively (Obaidat 2016).

CONCLUSIONS : The identified evidence shows that despite all efforts, asthma continues to be a significant burden to children, adults, and their caregivers. No recent costs related to burden of asthma have been identified, indicating an unmet need.