Cost analysis of GER-induced asthma: A controlled study vs. atopic asthma of comparable severity

SummaryBronchial asthma is a costly disease: while the role of pharmaceutical strategies was greatly emphasised in order to alleviate its economic burden, the aetiological approach to asthma has received much less attention from this point of view. The impact of gastro-oesophageal reflux (GER)-related asthma was assessed in comparison to atopic asthma in 262 matched patients, and the corresponding direct and indirect annual costs calculated. All subjects were screened by means of a 95-item self-questionnaire. The overall resource utilisation was calculated for the last 12 months. Drug-induced annual costs were €290.4 (interquartile range—iqr 32.8) in atopic and €438.4 (iqr 27.8) in GER-related asthma (p<0.001); expenditure for medical consultations and diagnostics were €166.1 (iqr 14.8) vs. €71.6 (iqr 11.0) (p<0.001), and €338.4 (20.0) vs. 186.9 (iqr 26.5) (p<0.001), respectively. Direct costs due to hospital admissions and indirect costs due to absenteeism were also higher in GER-related asthmatics: 2.201.7±90.0 vs. €567.1±11.0 (p<0.001), and €748.7±94.7 vs. €103.6±33.9 (p<0.001), respectively. The total annual cost per patient was €1246.7 (iqr 1979.6) in atopic and €3967.1 (iqr 3751.5) in GER-related asthma, p<0.001. In conclusion, GER-induced asthma has a more relevant economic impact on healthcare resources than atopic asthma. Although further studies are needed, present data tend to demonstrate that when facing difficult asthma (GER-related asthma in this case), the aetiological assessment of the disease plays a critical role in optimising the approach to patients’ needs.