Medical costs and health care utilization associated with asthma
and the variation by treatment are poorly understood.
Objective
To compare single controller inhaled corticosteroid (ICS) to other asthma drug regimens on medical
costs and utilization.
Methods
Direct medical costs and utilization were captured from administrative electronic databases from continuously enrolled members with asthma age 5 years or older with drug coverage. Asthma patients were identified during 2002, categorized into 14 asthma drug groups on the basis of 2003 prescription records, and had total medical costs and utilization determined in 2004 adjusting for demographics, insurance types, asthma risk, co morbidity, and propensity scores
Results
A total of 96,631 patients met the study eligibility criteria. Patients were (mean ± SD) age 38 ± 23 years and were 57% female, 14% Medicare, 4% Medicaid, and had a median family income (mean ± SD) of $64,967 ± $29,285. Total unadjusted direct medical costs/patient/year averaged $3745 ($3298 low
asthma risk vs. $6797 high asthma risk; P < .001). Adjusted total and asthma drug costs were
significantly lower with single controller ICS compared with single controller leukotriene modifiers,
long-acting ?-agonists, and theophylline and most combination controller regimens (P < .001 for all comparisons). In addition, single controller ICS compared with single controller leukotriene modifiers
and combination controllers was associated with significantly lower asthma-related utilization
Conclusion
Total direct costs and asthma-related utilizations are meaningfully less in the year after being
dispensed single controller ICS compared with single controller leukotriene modifiers or most
combination controllers.
