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

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
• phenotypes
• allergic
• non-allergic
• asthma
• healthcare resource utilization
• productivity

Acknowledgements

The authors received editorial assistance in the development of this manuscript from Claire Lavin and Jessica Donaldson-Jones of Fishawack Communications Ltd., Abingdon, UK, which was funded by Novartis Pharmaceuticals Corporation, NJ, USA. The final responsibility for the content lies with the authors.

Declaration of interest

PWS has received consulting fees (Novartis); and has received grants (Novartis). MJL has received consulting fees (AstraZeneca, Novartis, Optinose, Sanofi); has received speaker honorarium (AstraZeneca, Optinose); has received grants (AstraZeneca, Roche, Stallergenes); and has received travel/accommodations/meeting expenses (Florida Allergy, Asthma & Immunology Society). VHG has received consulting fees/honorarium (Regis University, Denver, CO, USA). AK and BO are employees of Novartis Pharmaceuticals Corporation with stock/stock options. JL is an employee of Novartis Pharmaceuticals Corporation and has stock/stock options in Intercept Pharmaceuticals, Inc. DJM has received consulting fees/honorarium (AstraZeneca, GSK, Novartis, Sanofi, Sunovion).

Additional information

Funding

The study was supported by Novartis Pharmaceuticals Corporation, NJ, USA.