The economic impact of uncontrolled asthma among treated, adherent patients with persistent asthma
Monday, March 5, 2018
South Hall A2 (Convention Center)
Lulu K Lee, Njira L Lugogo, Colleen Carpinella, Rinat Ariely, Susan Gabriel, Giselle Mosnaim
RATIONALE: Research on the economic burden of treated, adherent asthma is lacking. This study compared economic outcomes between controlled versus uncontrolled treated, adherent patients with persistent asthma.

METHODS: Controlled (N=242) and uncontrolled (N=645) treated, adherent patients with persistent asthma were identified from the 2015 and 2016 US National Health and Wellness Survey. Adherence was assessed with the Morisky Medication Adherence Scale
(MMAS-8 ©); patients with medium/high adherence were considered “adherent”. The Asthma Control Test (ACT; uncontrolled: scores ≤19; controlled: scores 20-25) assessed control. Economic outcomes included the Work Productivity and Activity Impairment-General Health Scale (WPAI-GH), health resource utilization (HRU), annual indirect and direct costs. Main analyses utilized generalized linear models.

RESULTS: Sample mean age was 49 years; 66.7% female. Uncontrolled vs. controlled patients experienced 1.4 times greater work productivity loss (adjusted means=34.96% vs. 25.21%, p=.036) resulting in 1.5 times higher annual indirect costs (adjusted means=$11,537 vs. $7,630, p=.016). Uncontrolled vs. controlled patients incurred twice as many annual hospitalizations (adjusted means=0.26 vs. 0.12, p<.001) and significantly more medical visits (emergency room: adjusted means=0.53 vs. 0.31, p=.003; healthcare provider: adjusted means=7.83 vs. 6.14, p=.011); incurring 1.5 times higher annual direct costs (adjusted means=$31,793 vs. $21,240, p<.001).

CONCLUSIONS: Uncontrolled asthma in treated, apparently adherent patients was associated with higher work impairment, HRU, and costs compared with controlled asthma. Significant unmet need in asthma management, independent of adherence or asthma severity, was demonstrated. Better understanding of patients’ treatment needs could aid in achieving improved asthma control and reducing the economic burden associated with uncontrolled asthma.