AB026. Excess medical cost in patients with asthma and the role of comorbidity
Session 3.1: Healthcare Resource Utilisation

AB026. Excess medical cost in patients with asthma and the role of comorbidity

Wenjia Chen1,2, Larry D. Lynd1,3, J. Mark FitzGerald2,4, Carlo A. Marra1,3, Robert Balshaw5, Teresa To6, Hamid Tavakoli2,4, Mohsen Sadatsafavi2,4; for the Canadian Respiratory Research Network

1Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; 2Institute for Heart and Lung Health, Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada; 3Centre for Health Evaluation and Outcome Sciences, Providence Health, St. Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada; 4Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, BC V5Z 1M9, Canada; 5BC Centre for Disease Control. Vancouver, BC V5Z 4R4, Canada; 6The hospital for sick children, University of Toronto, Toronto, Ontario M5G 1X8, Canada


Background: Comorbid conditions are prevalent in asthma patients but its impact on the economic burden of asthma is not well understood. To estimate the excess direct medical costs in patients with asthma, accounting for both the costs attributable to asthma and to comorbidities.

Methods: We created a propensity-score matched cohort of individuals aged 5 to 55 years between 1997 and 2012 with incident asthma and a comparison group of individuals without asthma from the health administrative data of British Columbia (BC), Canada. Sixteen major disease categories were identified using the International Classification of Diseases (ICD) codes. Excess costs [in 2013 Canadian dollars, ($)] were defined as the adjusted difference in total costs between the two groups.

Results: There were 145,742 individuals in both asthma and comparison groups. Average excess costs were $1,186.5/person-year (95% CI: 1,130.4–1,242.6) overall, of which $145.2 (143.0–147.4) were attributable to asthma and $787.7 (95% CI: 743.7, 831.7) to major comorbidity classes. Psychological disorders were the largest component of excess comorbidity costs, followed by other respiratory diseases, digestive disorders and diseases of nervous system. Comorbidity-attributable excess costs greatly increased with age but did not increase over the 10-year course of asthma.

Conclusions: In the asthma group, the excess costs attributable to comorbidity are five-times higher than costs attributable to asthma, which aggregated over age. In evaluating options for asthma management, consideration of asthma-related costs alone may result in sub-optimal policies and clinical decisions.

Keywords: Asthma; comorbid; economic burden; costs


doi: 10.21037/jtd.2016.s026


Cite this abstract as: Chen W, Lynd LD, FitzGerald JM, Marra CA, Balshaw R, To T, Tavakoli H, Sadatsafavi M; for the Canadian Respiratory Research Network. Excess medical cost in patients with asthma and the role of comorbidity. J Thorac Dis 2016;8(Suppl 5):AB026. doi: 10.21037/jtd.2016.s026

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