OBJECTIVES: SOPHIA is a program developed by the French Health Insurance. The program includes a free access information website, provision of leaflets, and regular phone calls from an asthma nurse, in order to promote self-management and adherence to asthma treatments.

The objective of this study was to evaluate the effect of the program on medication and health care use in adult asthma patients at one year.

METHODS: A controlled before-after study was conducted within the SNIIRAM (claims database of the French Health Insurance). Subjects 18 to 44 years old in 2014, receiving at least 2 asthma medications deliveries in 2013, and covered by the general scheme of Health insurance were included. The program was implemented in 2015 in 18 French departments. Each eligible subject from pilot departments (i.e. the eligibles) was matched with an eligible subject from a department without the program (i.e. a control) on a propensity score. The primary endpoint was the ratio controller/total asthma medications.

RESULTS: A total of 99,578 pairs were analyzed. No impact of the program was observed on the primary endpoint (OR=0.997). The program was associated with an increased total number of anti-asthma drug packs dispensed (slope=0.36, p<0.0001).

A non-significant decrease in the number of days of sick leave (slope =-0.09) and in the percentage of subjects with sick leave (OR=0.96) was observed.

In terms of asthma-related costs (reimbursed), the program was associated with increased asthma medication expenditure (+€15, p=0.02) and a decrease (not statistically significant) of sick leave expenditures.

CONCLUSIONS: In this very early evaluation, the program did not show a clear impact on the majority of endpoints. This could be explained by the small proportion of participants to the program (10%) within the eligible population and the large inclusion criteria. Analysis of a more specific asthmatic population revealed more favorable impact of the program.