Economic burden of severe asthma treatment: A real-life study

Background: Individuals with severe asthma represent 5%–10% of the general asthmatic population. Despite the use of biologic drugs during clinical management, inadequate control of the disease has translated into high economic impact. In Mexico, however, these costs have not yet been assessed. Metho...

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Main Authors: Jesús López-Tiro, MD, Angelica Contreras-Contreras, MD, M. Eunice Rodríguez-Arellano, PhD, Paula Costa-Urrutia, PhD
Format: Article
Language:English
Published: Elsevier 2022-07-01
Series:World Allergy Organization Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1939455122000382
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author Jesús López-Tiro, MD
Angelica Contreras-Contreras, MD
M. Eunice Rodríguez-Arellano, PhD
Paula Costa-Urrutia, PhD
author_facet Jesús López-Tiro, MD
Angelica Contreras-Contreras, MD
M. Eunice Rodríguez-Arellano, PhD
Paula Costa-Urrutia, PhD
author_sort Jesús López-Tiro, MD
collection DOAJ
description Background: Individuals with severe asthma represent 5%–10% of the general asthmatic population. Despite the use of biologic drugs during clinical management, inadequate control of the disease has translated into high economic impact. In Mexico, however, these costs have not yet been assessed. Methods: A retrospective cohort study was carried out in 2018 and 2019 at Regional Hospital Lic. Adolfo López Mateos, ISSSTE. The assessment of direct costs included pharmacological treatment, clinical tests, days of hospitalization, admissions to the emergency room, and scheduled consultations. The evaluation involved 2 groups of patients—with controlled severe asthma (CSA) and uncontrolled severe asthma (UCSA)—according to presence of exacerbations. Results: 60 patients (18–75 years old, 51 women) were included in the study. In 2018, 23 of them (38.3%) were categorized as belonging to the UCSA group; in 2019, 22 patients (36.7%) were in this condition (exacerbations: median = 1.5, maximum = 6). Of the 60 patients, 12 (20%) presented between 2 and 9 exacerbations in the study's two-year period (median = 3) after between 4 and 10 years (median = 7.8) of complementary anti-immunoglobulin E (IgE) therapy with omalizumab. The cost for all patients in the 2018–2019 period was 993,289.60 USD. The mean cost per patient was higher for those with UCSA (16,392 USD) than for those with CSA (16,246 USD, p = 0.02). We found a positive association between cost and exacerbations, with an increase of 350 USD per exacerbation (p˂0.0001). Our results indicate that 62% of patients respond to complementary anti-IgE treatment, while 38%—and especially 20%—do not respond optimally to this treatment. Conclusions: Poor asthma control in this latter group of 38% of patients leads to lower quality of life and higher costs associated with pharmacological treatment.
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spelling doaj.art-ec9978fdd4204fc48dbf91930ead2aeb2022-12-22T03:04:25ZengElsevierWorld Allergy Organization Journal1939-45512022-07-01157100662Economic burden of severe asthma treatment: A real-life studyJesús López-Tiro, MD0Angelica Contreras-Contreras, MD1M. Eunice Rodríguez-Arellano, PhD2Paula Costa-Urrutia, PhD3Department of Allergy and Clinical Immunology, Regional Hospital Lic. Adolfo López Mateos, ISSSTE, Mexico City, 01030, MexicoDepartment of Allergy and Clinical Immunology, Regional Hospital Lic. Adolfo López Mateos, ISSSTE, Mexico City, 01030, MexicoGenomic Medicine Laboratory, Regional Hospital Lic. Adolfo López Mateos, ISSSTE, Mexico City, 01030, MexicoGenomic Medicine Laboratory, Regional Hospital Lic. Adolfo López Mateos, ISSSTE, Mexico City, 01030, Mexico; Corresponding author.Background: Individuals with severe asthma represent 5%–10% of the general asthmatic population. Despite the use of biologic drugs during clinical management, inadequate control of the disease has translated into high economic impact. In Mexico, however, these costs have not yet been assessed. Methods: A retrospective cohort study was carried out in 2018 and 2019 at Regional Hospital Lic. Adolfo López Mateos, ISSSTE. The assessment of direct costs included pharmacological treatment, clinical tests, days of hospitalization, admissions to the emergency room, and scheduled consultations. The evaluation involved 2 groups of patients—with controlled severe asthma (CSA) and uncontrolled severe asthma (UCSA)—according to presence of exacerbations. Results: 60 patients (18–75 years old, 51 women) were included in the study. In 2018, 23 of them (38.3%) were categorized as belonging to the UCSA group; in 2019, 22 patients (36.7%) were in this condition (exacerbations: median = 1.5, maximum = 6). Of the 60 patients, 12 (20%) presented between 2 and 9 exacerbations in the study's two-year period (median = 3) after between 4 and 10 years (median = 7.8) of complementary anti-immunoglobulin E (IgE) therapy with omalizumab. The cost for all patients in the 2018–2019 period was 993,289.60 USD. The mean cost per patient was higher for those with UCSA (16,392 USD) than for those with CSA (16,246 USD, p = 0.02). We found a positive association between cost and exacerbations, with an increase of 350 USD per exacerbation (p˂0.0001). Our results indicate that 62% of patients respond to complementary anti-IgE treatment, while 38%—and especially 20%—do not respond optimally to this treatment. Conclusions: Poor asthma control in this latter group of 38% of patients leads to lower quality of life and higher costs associated with pharmacological treatment.http://www.sciencedirect.com/science/article/pii/S1939455122000382Severe asthmaEconomic burdenCost estimationBiological drugsReal-life study
spellingShingle Jesús López-Tiro, MD
Angelica Contreras-Contreras, MD
M. Eunice Rodríguez-Arellano, PhD
Paula Costa-Urrutia, PhD
Economic burden of severe asthma treatment: A real-life study
World Allergy Organization Journal
Severe asthma
Economic burden
Cost estimation
Biological drugs
Real-life study
title Economic burden of severe asthma treatment: A real-life study
title_full Economic burden of severe asthma treatment: A real-life study
title_fullStr Economic burden of severe asthma treatment: A real-life study
title_full_unstemmed Economic burden of severe asthma treatment: A real-life study
title_short Economic burden of severe asthma treatment: A real-life study
title_sort economic burden of severe asthma treatment a real life study
topic Severe asthma
Economic burden
Cost estimation
Biological drugs
Real-life study
url http://www.sciencedirect.com/science/article/pii/S1939455122000382
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