The economic impact of severe asthma to low-income families.
BACKGROUND
To estimate the direct and indirect costs of severe asthma and the economic impact of its management to low-income families in Salvador, Brazil.


METHODS
One hundred and ninety-seven patients with severe asthma and referred to a state-funded asthma center providing free treatment were evaluated. At registration, they were asked about family cost-events in the previous year and had a baseline assessment of lung function, symptoms and quality of life. During the subsequent year, they were reassessed prospectively.


RESULTS
One hundred-eighty patients concluded a 12-month follow-up. Eighty-four percent were female patients, and the median family income was US$ 2955/year. Forty-seven percent of family members had lost their jobs because of asthma. Total cost of asthma management took 29% of family income. After proper treatment, asthma control scores improved by 50% and quality of life by 74%. The income of the families increased by US$ 711/year, as their members went back to work. The total cost of asthma to the families was reduced by a median US$ 789/family/year. Consequently, an annual surplus of US$ 1500/family became available.


CONCLUSIONS
Family costs of severe asthma consumed over one-fourth of the family income of the underprivileged population in a middle-income country. Adequate management brings major economic benefit to individuals and families.
Franco
R
R
Programa para o Controle da Asma e da Rinite Alérgica na Bahia (ProAR), Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.
Nascimento
H F
HF
Cruz
A A
AA
Santos
A C
AC
Souza-Machado
C
C
Ponte
E V
EV
Souza-Machado
A
A
Rodrigues
L C
LC
Barreto
M L
ML
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000191:economics*; D001938:Brazil; D001993:Bronchodilator Agents / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D017281:Cost of Illness; D004983:Ethanolamines / Q000627:therapeutic use; D005190:Family; D005260:Female; D005280:Fenoterol / Q000627:therapeutic use; D000068759:Formoterol Fumarate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000191:economics*; D011788:Quality of Life; D012220:Rhinitis / Q000188:drug therapy
D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D004983:Ethanolamines; D005280:Fenoterol; D019819:Budesonide; D000068759:Formoterol Fumarate