title: The association between asthma control, health care costs, and quality of life in France and Spain.
abstract: BACKGROUND
  Current asthma management guidelines are based on the level of asthma control. The impact of asthma control on health care resources and quality of life (QoL) is insufficiently studied. EUCOAST study was designed to describe costs and QoL in adult patients according to level of asthma control in France and Spain.
  
  
  METHODS
  An observational cost of illness study was conducted simultaneously in both countries among patients age greater or equal to 18 with a diagnosis of asthma for at least 12 months. Patients were recruited prospectively by GPs in 2010 in four waves to avoid a seasonal bias. Health care resources utilization of the three months before the inclusion was collected through physician questionnaires. Asthma control was evaluated using 2009 GINA criteria over a 3-month period. QoL was assessed using EQ-5D-3L®.
  
  
  RESULTS
  2,671 patients (France: 1,154; Spain: 1,517) were enrolled. Asthma was controlled in 40.6% [95% CI: 37.7%-43.4%] and 29.9% [95% CI: 27.6%-32.3%] of French and Spanish patients respectively.For all types of costs, the percentage of patients using health care resources varied significantly according to the level of asthma control. The average cost (euros/3-months/patient) of controlled asthma was €85.4 (SD: 153.5) in France compared with €314.0 (SD: 2,160.4) for partially controlled asthma and €537.9 (SD: 2,355.7) for uncontrolled asthma (p<0.0001). In Spain, the corresponding figures were €152.6 (SD: 162.1), €241.2 (SD: 266.8), and €556.8 (SD: 762.4). EQ-5D-3L® score was higher (p<0.0001) in patients with controlled asthma compared to partially controlled and uncontrolled asthma in both countries (respectively 0.88; 0.78; 0.63 in France and 0.89; 0.82; 0.69 in Spain).
  
  
  CONCLUSIONS
  In both countries, patients presenting with uncontrolled asthma had a significantly higher asthma costs and lower scores of Qol compared to the others.
authors.affiliation: Cemka-Eval, 43 Boulevard du Maréchal Joffre, Bourg-la-Reine, F-92340, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Doz
authors.forename: Christos
authors.initials: C
authors.lastname: Chouaid
authors.forename: Laure
authors.initials: L
authors.lastname: Com-Ruelle
authors.forename: Eduardo
authors.initials: E
authors.lastname: Calvo
authors.forename: Max
authors.initials: M
authors.lastname: Brosa
authors.forename: Julien
authors.initials: J
authors.lastname: Robert
authors.forename: Laurent
authors.initials: L
authors.lastname: Decuypère
authors.forename: Celine
authors.initials: C
authors.lastname: Pribil
authors.forename: Alicia
authors.initials: A
authors.lastname: Huerta
authors.forename: Bruno
authors.initials: B
authors.lastname: Detournay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D005102:Health Expenditures / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012044:Regression Analysis; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D055815:Young Adult