title: A budget impact analysis of bronchial thermoplasty for severe asthma in clinical practice.
abstract: BACKGROUND
  Fully 80% of asthma-related deaths occur in patients with uncontrolled disease and 50% of all costs are attributable to this subgroup. Although asthma is costly, direct costs and loss of productivity have only recently been extensively studied, partly as a result of the introduction of new and more costly treatment options. A 5-year population-based budget impact model in the perspective of the Emilia Romagna of Italy regional healthcare service compared the impact of adding adjuvant bronchial thermoplasty (BT) for a population of patients with severe, uncontrolled asthma treated with standard care (SC) with or without adjuvant omalizumab (OMAL).
  
  
  METHODS
  The model compared the budget impact of two scenarios: the first examined a population treated either with SC alone or with administration of OMAL concurrent to SC; the second examined a population treated either with SC alone or with either the concurrent administration of OMAL or BT.
  
  
  RESULTS
  The cost for treating asthmatics patients in Emilia Romagna with BT would require 17.7 million Euros during the initial year; these costs would be offset by savings of 1 million Euros, 10.5 million Euros, and up to 19.2 million Euros during third, fourth, and fifth years, respectively.
  
  
  CONCLUSIONS
  Despite the increase in direct costs, the complementary treatment of patients with either BT or OMAL in addition to SC may not only help the clinician to meet the needs of a greater number of patients, but also decreases emergency room visits and hospitalizations, as well as generates economic savings in the longer term.
authors.affiliation: Department of Cardiology, Thoracic, Vascular Surgery, and Critical Care Medicine, Pulmonology Unit, Azienda Ospedaliera Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Viale Risorgimento 56, 42123, Reggio Emilia, Italy, menzella.francesco@asmn.re.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Menzella
authors.forename: Luigi
authors.initials: L
authors.lastname: Zucchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Piro
authors.forename: Carla
authors.initials: C
authors.lastname: Galeone
authors.forename: Claudia
authors.initials: C
authors.lastname: Castagnetti
authors.forename: Nicola
authors.initials: N
authors.lastname: Facciolongo
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000628:therapy*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D007558:Italy; D000069444:Omalizumab / Q000627:therapeutic use; D012720:Severity of Illness Index
chemical_list: D018927:Anti-Asthmatic Agents; D000069444:Omalizumab