Obstructive Lung Diseases: Airways 1 |

The Impact of Adherence and Exacerbation Frequency on Health Care Utilization and Associated Direct Costs in Severe Asthma FREE TO VIEW

Shiyuan Zhang, MS; Tam Dang-Tan, PhD; Afisi Ismaila, PhD; Claire Tacon, PhD; Jonas Daugherty; Ruben Tavares, PhD; Emma Goodall, PhD; Steven Smith, PhD; Melissa Stutz; Julie Vaillancourt; Daria Parsons; Xiwu Lin, PhD; Gilbert Nadeau; Alexander Simidchiev, MD; John Sampalis, PhD
Author and Funding Information

GlaxoSmithKline, Mississauga, ON, Canada

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):827A. doi:10.1016/j.chest.2016.08.927
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Severe asthma represents a small proportion of asthma cases yet accounts for a disproportionate amount of resource expenditure. This study aimed to characterize health care resource utilization (HCRU) and associated direct health care costs (DHCs) among severe asthmatics in Quebec.

METHODS: This observational retrospective cohort study utilized claims data from Quebec Health Insurance administrative databases. Patients ≥12 years old with an incident diagnosis of asthma/severe asthma based on GINA steps 4-5 were included. Asthma-related HCRU and associated DHCs were assessed overall and stratified by adherence, defined as an overall Medication Possession Ratio >=80%, and number of exacerbations/year. Poisson regression (medical HCRU) and Generalized Linear Models (prescription HCRU and DHC) were used to assess the impact of adherence and exacerbations on HCRU and DHCs, adjusted for duration of follow-up, age, gender, and Charlson Comorbidity Index.

RESULTS: Overall, 9716 patients were included (median follow-up 4.90 years). The mean age was 47.09 years, and 62.5% were female. An average 68.11 physician visits, 20.00 specialist visits, 5.14 emergency room visits, and 2.90 hospitalizations were reported per 100 person-years. Average adjusted DHC of a severe asthmatic was approximately $1,900 CAD/year, with non-adherent patients costing more per year than adherent patients ($1,937 vs. $1,596, P<0.001). ), Patients experiencing ≥2 exacerbations/year reported adjusted DHCs more than 5 times that of the overall cohort ($10,384).

CONCLUSIONS: The results of this analysis show that patients with severe asthma represent a significant burden, both in terms of HCRU and DHCs. This is especially true for severe asthma patients who experience ≥2 exacerbations per year, as the DHCs associated with these patients is upwards of $10,000 CAD/year. These findings add to the current evidence related to the known disproportionate resource expenditure of severe asthmatics.

CLINICAL IMPLICATIONS: Severe asthma represents a significant burden of illness to Quebec society, which is compounded by lack of adherence to medication and increase in disease severity, as determined based on exacerbation frequency. Funded by GSK: HO-14-14916

DISCLOSURE: Shiyuan Zhang: Employee: GSK employee Tam Dang-Tan: Employee: GSK employee at time of preparation of this work Afisi Ismaila: Employee: GSK employee Claire Tacon: Employee: GSK employee Jonas Daugherty: Employee: GSK employee at time of preparation of this work Ruben Tavares: Employee: GSK employee Emma Goodall: Employee: GSK employee Steven Smith: Employee: GSK employee Melissa Stutz: Other: GSK Sponsored study, JSS was paid for the conduct of the research. Julie Vaillancourt: Other: GSK Sponsored study, JSS was paid for the conduct of the research. Daria Parsons: Other: GSK Sponsored study, JSS was paid for the conduct of the research. Xiwu Lin: Employee: GSK employee Gilbert Nadeau: Employee: GSK employee Alexander Simidchiev: Employee: GSK employee John Sampalis: Other: GSK Sponsored study, JSS was paid for the conduct of the research.

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