A 4-YEAR ASSESSMENT OF SEVERE AND NON-SEVERE ASTHMA IN A REAL-WORLD SETTING
Author(s)
Bhash Parasuraman, PhD, Value Demonstration Leader1, Eugene Bleecker, MD, Professor of Medicine2, Donald Tashkin, MD, Professor of Medicine3, Stephen Peters, MD, PhD, Professor of Medicine2, Aidan Long, MD, Clinical Director of Allergy4, Richard O'Connor, MD, Director, Dept. of Quality Management5, Robert Boggs, PhD, Formerly AstraZeneca61AstraZeneca, Wilmington, DE, USA; 2 Wake Forest University, Winston-Salem, NC, USA; 3 UCLA, Los Angeles, CA, USA; 4 Massachusetts General Hospital, Boston, MA, USA; 5 Sharp Rees-Stealy Medical Group, San Diego, CA, USA; 6 Formerly AstraZeneca, Wilmington, DE, USA
OBJECTIVES: To examine health outcomes and costs for patients with severe and non-severe asthma in a managed care setting over a 4-year period. METHODS: An administrative claims database (8.8 million lives) was analyzed (June 2000 - May 2004). Patients aged =12 years with an ICD-9 code for asthma and =2 claims/year for asthma medication were included; those with other significant respiratory conditions were not. Patients using omalizumab, continuous oral corticosteroids (OCS), Advair 500/50, or high-dose inhaled corticosteroids in combination with any other asthma medication were considered to have severe asthma. Outcomes in years 2-4 for patients with severe asthma in year 1 were compared with those of patients with non-severe asthma in year 1. Lack of control was defined as an asthma-related hospitalization or emergency department (ED) visit, OCS burst for asthma, more than 4 clinic visits for asthma per year or more than 2 per quarter, or more than 5 prescriptions for asthma rescue medication per year. RESULTS: Of 3998 patients identified (mean age=41 years, 65% female), 594 (15%) had severe asthma in year 1. Patients with severe asthma had significantly more hospitalizations per 1000 patients per year (7.2 vs 4.3; p<0.001), ED visits per 1000 patients per year (8.8 vs 6.1; p=0.004), clinic visits for asthma per patient per year (2.93 vs 1.98; p<0.001), asthma costs per patient per year ($1,331 vs $817; p<0.001), and lack of control events per 1000 patients per year (547 vs 462; p<0.001) than patients with non-severe asthma. CONCLUSION: Patients with severe asthma used significantly more health care resources than patients with non-severe asthma. In addition, a significant number of patients in both groups met the definition for lack of control.
Conference/Value in Health Info
2007-05, ISPOR 2007, Arlington, VA, USA
Value in Health, Vol. 10, No.3 (May/June 2007)
Code
PAA9
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Respiratory-Related Disorders