Poor control increases the economic cost of asthma. A multicentre population-based study.
OBJECTIVE
Up to now, few cost-of-illness (COI) studies have estimated the cost of adult asthma at an individual level on general population samples. We sought to evaluate the cost of current asthma from the societal perspective in young Italian adults and the determinants of cost variation.


METHODS
In 2000, a COI study was carried out in the frame of the Italian Study on Asthma in Young Adults on 527 current asthmatics (20-44 years) screened out of 15,591 subjects from the general population in seven centres. Detailed information about direct medical expenditures (DMEs) and indirect costs due to asthma was collected at an individual level over the past 12 months.


RESULTS
The mean annual cost per patient was EUR 741 (95% CI: 599-884). DMEs represented 42.8% of the total cost, whereas the remaining 57.2% was indirect costs. The largest component of DMEs was medication costs (47.3%; 23.0% was due to hospitalization). The mean annual cost per patient ranged from EUR 379 (95% CI: 216-541)for well-controlled asthmatics to EUR 1,341 (95% CI: 978-1,706) for poorly controlled cases that accounted for 46.2% of the total cost. Poor control, coexisting chronic cough and phlegm, and low socio-economic status were significantly associated with high DMEs and indirect costs.


CONCLUSIONS
In Italy, asthma-related costs were substantial even in unselected patients and were largely driven by indirect costs. Since about half of the total cost was due to a limited proportion of poorly controlled asthmatics, interventions aimed at these high-cost patients could reduce the economic burden of the disease.
Accordini
Simone
S
Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy. simone.accordini@univr.it
Bugiani
Massimiliano
M
Arossa
Walter
W
Gerzeli
Simone
S
Marinoni
Alessandra
A
Olivieri
Mario
M
Pirina
Pietro
P
Carrozzi
Laura
L
Dallari
Rossano
R
De Togni
Aldo
A
de Marco
Roberto
R
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D018927:Anti-Asthmatic Agents / Q000191:economics* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology*; D002648:Child; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004180:Direct Service Costs / Q000706:statistics & numerical data; D005102:Health Expenditures; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
D018927:Anti-Asthmatic Agents