OBJECTIVES: The economic burden of asthma is over $50 billion each year. Medication Management (MM) and Asthma Medication Ratio (AMR) are Healthcare Effectiveness Data and Information Set (HEDIS) measures that may be useful for evaluating asthma control interventions aimed at mitigating this burden. To better understand the economic impact of HEDIS score attainment, healthcare resource use (HRU) and costs were compared among patients who attained a satisfactory HEDIS score versus those who did not.

METHODS: Retrospective cohort analysis of US claims data linked to ambulatory electronic medical records conducted in patients aged ≥5 years with evidence of persistent asthma and continuous enrollment from 5/2015 to 4/2017. Patients were classified into two mutually exclusive cohorts based on attainment of ≥1 HEDIS score (MM or AMR) during the 1-year baseline period. MM attainment was defined as evidence of treatment with asthma control medication (ACM) for ≥75% of the period. AMR attainment was defined as a ratio of ACM to total asthma medications of ≥0.5. HRU and costs were compared in the 1-year follow-up period across cohorts.

RESULTS: A total of 32,750 patients were identified (24,647 attained a satisfactory HEDIS score; 8,103 did not). During the follow-up period, the ‘attained’ cohort had lower hospitalization and emergency department (ED) visit rates versus those who did not attain a satisfactory HEDIS score (7.4% vs. 11.6%; and 24.7% vs. 38.2%, respectively; p<0.0001). Respectively, total costs were also lower for the ‘attained’ cohort ($14,889 vs. $17,471), as were inpatient ($2,423 vs. $3,870), ED ($408 vs. $739), and outpatient costs ($6,005 vs. $6,811), all p<0.0001. Prescription medication costs were similar across cohorts ($6,052 vs. $6,051, p=0.996).

CONCLUSIONS: HEDIS score attainment was associated with lower HRU and costs. This may signal the importance of monitoring adherence and persistence in asthma treatment in improving economic outcomes in this patient population.