The economic impact of children dispensed asthma medications without an asthma diagnosis.
OBJECTIVE
To compare the resource utilization and healthcare costs of children with a diagnosis of asthma, children dispensed asthma medications but without a diagnosis of asthma, and control children.


METHODS
Children 0 to 17 years old were identified from an integrated managed-care database during calendar year 2001. They were compared on the basis of the presence of a medical claim for asthma (Dx cohort); a prescription for an asthma controller or reliever medication (excluding oral corticosteroids) but without an asthma diagnosis (Rx cohort), and control children. Using medical and pharmacy claims, resource utilization and costs were compared across cohorts.


RESULTS
Children in both the Dx and Rx cohorts had significantly greater nonasthma and total all-cause annual healthcare costs compared with control children. The Dx and Rx cohorts had higher rates of nonasthma emergency department visits and hospitalizations. The risk of an oral corticosteroid dispensed was 14-fold and 7-fold greater for the Dx and Rx cohorts, respectively, compared with the control children. These findings were consistent in infant, toddler, school-age, and adolescent groups.


CONCLUSIONS
Children dispensed asthma medications but lacking an asthma diagnosis have considerable morbidity and incur high healthcare resource utilization. This study suggests that better recognition of pediatric asthma is warranted.
Stempel
David A
DA
Infomed Northwest Bellevue and University of Washington, Bellevue, Washington 98004, USA. econmed@msn.com
Spahn
Joseph D
JD
Stanford
Richard H
RH
Rosenzweig
Jacqueline R Carranza
JR
McLaughlin
Trent P
TP
D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000191:economics* / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012189:Retrospective Studies
D018927:Anti-Asthmatic Agents