The total economic burden of uncontrolled asthma in the United States during the next 20 years is estimated to be $963.5 billion when indirect costs are included, and adults and adolescents are estimated to lose >15 million quality-adjusted life years (QALYs) during the next 2 decades, according to a study published in the American Journal of Respiratory and Critical Care Medicine.

Despite effective treatments, many Americans with asthma are not achieving sustained control — a preventable burden that is taking a large toll at both the personal and population level. Researchers built a probabilistic model to link state-specific estimates of asthma prevalence, population growth and aging, and asthma control levels, as well as several meta-analyses estimating the adjusted differences in use of healthcare resources, QUALYs, and productivity loss across the asthma control levels. This information was used to predict the future excess economic and health burden associated with uncontrolled asthma during the next 20 years through national and state-level projections of total direct and indirect costs (2018 dollars) and QUALYs lost between 2019 and 2038.

The total 20-year estimated direct costs associated with uncontrolled asthma in adolescents and adults in the United States are $300.6 billion (95% CI, $190.1-$411.1 billion), and when the indirect productivity loss costs are added, this total economic burden increases to $963.5 billion (95% CI, $664.1-$1262.9 billion). American adults and adolescents with uncontrolled asthma will lose an estimated 15.46 million QUALYs during the next 20 years as well (95% CI, 12.77-18.14 million).

Limitations of this study included an assumption that the overall prevalence of asthma across gender and age groups will stay the same during the projected period, variable definitions of asthma control between studies, and that the study did not include the pediatric population.

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The investigators concluded, “Our findings highlight the sizeable potential for cost saving and improvement in quality of life associated with better asthma control. Research into improving adherence to existing medications should be put on an equal footing with investments in novel asthma therapies. Many of the effective asthma therapies are now off-patent, and research and development in the private sector are understandably shifted towards developing novel therapies. However, healthcare management organizations, patient groups, governments, and society at large, will benefit from investing in areas with proven capacities for improving patient outcomes and reducing costs.”

Reference

Yaghoubi M, Adibi A, Safari A, FitzGerald JM, Sadatsafavi M; for the Canadian Respiratory Research Network. The projected economic and health burden of uncontrolled asthma in the United States [published online June 5, 2019]. Am J Respir Crit Care Med. doi:10.1164/rccm.201901-0016OC