Direct medical costs associated with atopic diseases among young children in Thailand.
OBJECTIVE
Allergic diseases are the most common childhood illness in Thailand. Their prevalence has been rising over time, with several studies having revealed substantial economic burden. However, no such study had yet been conducted for Thailand. The aim of this study was to estimate direct medical costs associated with atopic diseases among children aged 0-5 years in Thailand.


METHODS
A cost-of-illness model was constructed to estimate the total direct medical costs of atopic diseases comprising atopic dermatitis, chronic rhinitis, asthma (i.e., recurrent wheeze), and cow's milk allergy. The model employed a prevalence-based approach, considering a total number of atopic cases in 2010. Direct medical costs were estimated using a bottom-up analysis with the estimation of the quantity of healthcare resource use and the unit costs. Epidemiological data were obtained from literature and Thai surveys, whereas treatment unit costs were from either a hospital database or Thai standard cost list. Expert opinion informed type, frequency, and quantity of medical resources utilized. Key limitations included lack of data-driven evidences on severity distribution for this particular age group, indirect costs, and medical resource use associated with each condition.


RESULTS
Total direct cost was estimated to be THB 27.8 billion (US$899 million). Treatments contributed largest to the total costs (46%), followed by inpatient care (37%), outpatient care (12%), and monitoring and labs (5%). Costs per treated patient were highest in cow's milk allergy (THB 64,383; US$2077), followed by rhinitis (THB 12,669; US$409), asthma (THB 9633; US$312), and atopic dermatitis (THB 5432; US$175).


CONCLUSIONS
Atopic diseases in young children are associated with substantial burden in direct medical costs to Thailand. These costs can be diminished through nutritional intervention recognized to effectively decrease the incidence of atopic diseases.
Pediatric Department, Faculty of Medicine, Chulalongkorn, University, Bangkok, Thailand.
Jarungchit
J
Ngamphaiboon
Thitima
T
Kongnakorn
Patrick
P
Detzel
Krittawan
K
Sirisomboonwong
Radek
R
Wasiak
D001249:Asthma / Q000191:economics; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000191:economics; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000191:economics; D017059:Models, Econometric; D015995:Prevalence; D012220:Rhinitis / Q000191:economics; D012720:Severity of Illness Index; D013785:Thailand / Q000453:epidemiology