English, Article edition: Factors Affecting UK Primary-Care Costs of Managing Patients with Asthma over 5 Years Roben Das Gupta; Julian F. Guest

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Physical Description
  • article
Language
  • English

Edition details

Title
  • Factors Affecting UK Primary-Care Costs of Managing Patients with Asthma over 5 Years
Author
  • Roben Das Gupta
  • Julian F. Guest
Physical Description
  • article
Notes
  • Objective: To determine the effect of age, disease severity and compliance on the annual primary-care cost of managing patients with asthma initially on British Thoracic Society British Guidelines on Asthma Management (BGAM) treatment steps 2/​3 over 5 years. Design and setting: A modelling study performed from the perspective of the UK's National Health Service (NHS). Study participants and interventions: A data set was created comprising 4519 patients with asthma in the DIN-link database who were prescribed twice-daily inhaled corticosteroids and who were on steps 2/​3 between 1 January and 31 December 1993. These patients were followed over 5 years. Methods: Asthma-related primary-care resource utilisation data obtained from the DIN-link database were stratified by patients' age, compliance and BGAM treatment step. Unit costs at 1999-2000 prices were applied to the resource use estimates to determine the mean annual cost per patient. Main outcome measures and results: High compliance with inhaled corticosteroids was not associated with a reduction in use of other primary-care resources, although the ratio of the number of prescriptions for inhaled corticosteroids to that for short-acting beta2-agonists increased, suggesting that patients' asthma was better controlled. Overall, the primary-care cost of managing a patient starting on steps 2/​3 was found to be most strongly influenced by whether that patient moved onto steps 4/​5 or continued to be managed on the same treatment step. If a patient continued to be managed at steps 2/​3, costs were influenced in descending order of impact by compliance, previous BGAM step and the patient's age. Conclusions: Better compliance with inhaled corticosteroids is likely to lead to better asthma control and fewer asthma attacks. Notwithstanding this, increasing compliance is likely to increase primary-care costs. Consequently increasing healthcare expenditure may be the inevitable consequence of improving asthma control.
  • Asthma, Corticosteroids, Cost analysis, Patient compliance, Pharmacoeconomics, Resource use
  • RePEc:wkh:phecon:v:21:y:2003:i:5:p:357-369
Language
  • English
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