Cost-effectiveness analysis of a state funded programme for control of severe asthma.
BACKGROUND
Asthma is one of the most common chronic diseases and a major economical burden to families and health systems. Whereas efficacy of current therapeutical options has been clearly established, cost-effectiveness analysis of public health interventions for asthma control are scarce.


METHODS
81 patients with severe asthma (12-75 years) joining a programme in a reference clinic providing free asthma medication were asked retrospectively about costs and events in the previous 12 months. During 12 months after joining the programme, information on direct and indirect costs, asthma control by lung function, symptoms and quality of life were collected. The information obtained was used to estimate cost-effectiveness of the intervention as compared to usual public health asthma management. Sensitivity analysis was conducted.


RESULTS
64 patients concluded the study. During the 12-months follow-up within the programme, patients had 5 fewer days of hospitalization and 68 fewer visits to emergency/non scheduled medical visits per year, on average. Asthma control scores improved by 50% and quality of life by 74%. The annual saving in public resources was US$387 per patient. Family annual income increased US$512, and family costs were reduced by US$733.


CONCLUSIONS
A programme for control of severe asthma in a developing country can reduce morbidity, improve quality of life and save resources from the health system and patients families.
Franco
Rosana
R
Programa para o Controle da Asma e da Rinite Alérgica na Bahia (ProAR), Faculdade de Medicina, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil. rosana_franco@terra.com.br
Santos
Andreia C
AC
do Nascimento
Harrison F
HF
Souza-Machado
Carolina
C
Ponte
Eduardo
E
Souza-Machado
Adelmir
A
Loureiro
Sebastião
S
Barreto
Maurício L
ML
Rodrigues
Laura C
LC
Cruz
Alvaro A
AA
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D001249:Asthma / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D001938:Brazil / Q000453:epidemiology; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D004522:Educational Status; D005260:Female; D006295:Health Resources / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D015397:Program Evaluation; D011788:Quality of Life; D012129:Respiratory Function Tests / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015996:Survival Rate
D000305:Adrenal Cortex Hormones