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Estimated cost of asthma in outpatient treatment: a real-world study.

Estimated cost of asthma in outpatient treatment: a real-world study.
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Costa E, Caetano R, Werneck GL, Bregman M, Araújo DV, Rufino R,


Costa E, Caetano R, Werneck GL, Bregman M, Araújo DV, Rufino R, (click to view)

Costa E, Caetano R, Werneck GL, Bregman M, Araújo DV, Rufino R,

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Revista de saude publica 2018 04 0952() 27 pii S0034-89102018000100221
Abstract
OBJECTIVE
To estimate the cost of diagnosis and treatment of asthma.

METHODS
We used the perspective of society. We sequentially included for 12 months, in 2011-2012, 117 individuals over five years of age who were treated for asthma in the Pneumology and Allergy-Immunology Services of the Piquet Carneiro Polyclinic, Universidade do Estado do Rio de Janeiro. All of them were interviewed twice with a six-month interval for data collection, covering 12 months. The cost units were identified and valued according to defined methods. We carried out a sensitivity analysis and applied statistical methods with a significance level of 5% for cost comparisons between subgroups.

RESULTS
The study consisted of 108 patients, and 73.8% of them were women. Median age was 49.5 years. Rhinitis was present in 83.3% of the individuals, and more than half were overweight or obese. Mean family income was U$915.90/month (SD = 879.12). Most workers and students had absenteeism related to asthma. Total annual mean cost was U$1,291.20/patient (SD = 1,298.57). The cost related to isolated asthma was U$1,155.43/patient-year (SD = 1,305.58). Obese, severe, and uncontrolled asthmatic patients had higher costs than non-obese, non-severe, and controlled asthmatics, respectively. Severity and control level were independently associated with higher cost (p = 0.001 and 0.000, respectively). The direct cost accounted for 82.3% of the estimated total cost. The cost of medications for asthma accounted for 62.2% of the direct costs of asthma.

CONCLUSIONS
Asthma medications, environmental control measures, and long-term health leaves had the greatest potential impact on total cost variation. The results are an estimate of the cost of treating asthma at a secondary level in the Brazilian Unified Health System, assuming that the treatment used represents the ideal approach to the disease.

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