Healthcare resource utilization, expenditures, and productivity in patients with asthma with and without allergies

J Asthma. 2020 Sep;57(9):959-967. doi: 10.1080/02770903.2019.1628253. Epub 2019 Jul 2.

Abstract

Objective: To compare healthcare resource utilization (HCRU), healthcare expenditures, and work productivity and activity impairment within a general asthma population with persistent asthma and evidence of allergy (PA-EA) and persistent asthma with no evidence of allergy (PA-NEA).Methods: We conducted a retrospective analysis of survey responses and claims from the Observational Study of Asthma Control and Outcomes (OSACO) study. Eligible patients with persistent asthma aged ≥12 years were sent four surveys over 15 months. Regression models were used to assess the association between: (1) PA-EA (defined as a positive response to a survey question about hay fever/seasonal allergies AND ≥1 diagnostic code for atopic conditions) and HCRU and expenditures; and (2) PA-EA and Work Productivity and Activity Impairment (WPAI)-Asthma questionnaire scores (vs. PA-NEA).Results: Adjusted data showed that, vs. PA-NEA (n = 312), patients with PA-EA (n = 971) incurred 1.34-times more all-cause prescriptions (95% confidence interval [CI], 1.20-1.48), $132.79 higher prescription costs (95% CI, $22.03-243.56), and $926.11 higher all-cause total healthcare costs (95% CI, $279.67-1572.54), per 4-month period. Patients with PA-EA were 4.1% less productive while working (95% CI, 3.75-4.48%) and experienced a 6.5% reduction in all activities (95% CI, 6.11-6.88%) vs. those with PA-NEA.Conclusions: Patients with PA-EA had greater HCRU, healthcare expenditures, and lower productivity compared with those patients with PA-NEA. These results highlight the burden of atopy in patients with persistent asthma and underscore the importance of allergic endotype identification for more vigilant disease management.

Keywords: Economics; allergic; asthma; healthcare resource utilization; non-allergic; phenotypes; productivity.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism
  • Adult
  • Aged
  • Asthma / complications
  • Asthma / economics*
  • Asthma / immunology
  • Asthma / therapy
  • Cost of Illness
  • Efficiency*
  • Female
  • Health Expenditures / statistics & numerical data*
  • Humans
  • Hypersensitivity / complications
  • Hypersensitivity / economics*
  • Hypersensitivity / immunology
  • Hypersensitivity / therapy
  • Male
  • Middle Aged
  • Observational Studies as Topic
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Retrospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires / statistics & numerical data
  • United States