The following is a summary of “Cost-Effectiveness and Impact on Health Care Utilization of Interventions to Improve Medication Adherence and Outcomes in Asthma and Chronic Obstructive Pulmonary Disease: A Systematic Literature Review,” published in the May 2024 issue of Allergy & Immunology by Boven, et al.

Poor adherence to maintenance therapies for asthma and chronic obstructive pulmonary disease (COPD) negatively affects health outcomes. Despite the proven efficacy and cost-effectiveness of programs aimed at improving adherence and persistence, such programs still need to be widely implemented, potentially due to concerns about implementation costs. For a study, researchers sought to conduct a systematic literature review and narrative synthesis to evaluate the cost-effectiveness of adherence-promoting programs for asthma and COPD and assess their impact on healthcare budgets directly or through healthcare resource use (HCRU).

Relevant publications covering the period from January 2000 to July 2021 were identified through Medline and PreMEDLINE (PubMed), Embase (Embase.com, Elsevier), and EconLit. Additional sources included clinical trial databases and selected conference proceedings.

Of 1,910 potential articles, 26 met the inclusion criteria and were subjected to data extraction. Among these, 11 studies directly assessed adherence, 15 conducted economic evaluations, and 17 examined HCRU. No studies included an analysis of biological medication use. Interventions to improve adherence were frequently found to be highly cost-effective, with some demonstrating dominant incremental cost-effectiveness ratios. Many studies reported reductions in direct costs and HCRU, such as fewer healthcare visits, hospital admissions, and decreased use of medications, including add-on/reliever treatments and antibiotics. Improvements in the use of maintenance treatments were noted in some studies. Favorable outcomes were consistently associated with counseling and/or digitally informed programs.

Interventions designed to promote adherence are generally cost-effective and often lead to reduced HCRU and associated costs. Programs that incorporate multidisciplinary care, one-to-one advice, and digitally enhanced communication offer the greatest benefits.

Reference: sciencedirect.com/science/article/pii/S2213219824000060