title: Medical cost burdens among nonelderly adults with asthma.
abstract: OBJECTIVE
  We used the 2003-2009 Medical Expenditure Panel Survey to evaluate average annual total and out-of-pocket expenditures by nonelderly adults with asthma.
  
  
  METHODS
  We divided patients diagnosed with asthma into 4 groups, based on whether or not they had had an asthma attack in the previous year (a crude marker for disease severity) and whether or not they reported using treatment for their asthma.
  
  
  METHODS
  For each group we calculated total and out-of-pocket average annual spending for hospital inpatient, hospital outpatient, emergency department, and physician office care, as well as for prescription drugs. These averages were adjusted to account for differences in respondents' overall health (presence of other co-morbidities, self-reported health status, and self-reported activity limitations), sociodemographic characteristics (age, sex, race/ethnicity, income), and insurance status.
  
  
  RESULTS
  We found that among the 4 groups, those who were receiving treatment but continued to experience asthma attacks had the highest total and out-of-pocket expenditures in all categories, consistent with their likely higher illness severity. However, patients who reported receiving treatment and did not experience attacks also reported relatively high adjusted total and out-of-pocket expenditures-most notably $536 per year out of pocket for prescription medications and $231 per year out of pocket for physician office visits. After adjustment, about the same proportion of patients in these 2 groups (13.5% who did not get treated and had attacks, and 13.8% who did get treated and avoided attacks) reported high financial burden.
  
  
  CONCLUSIONS
  Patients may experience financial challenges to appropriate self-management of asthma, even when they are able to avoid exacerbations.
authors.affiliation: Seamless Care Models Group, CMS Innovation Center, Centers for Medicare and Medicaid Services, 7500 Security Blvd, WB-15-64, Baltimore, MD 21244. E-mail: Emily.Carrier@cms.hhs.gov.
authors.forename: Emily
authors.initials: E
authors.lastname: Carrier
authors.forename: Peter
authors.initials: P
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000191:economics; D001249:Asthma / Q000191:economics*; D017281:Cost of Illness; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents