Direct and indirect costs associated with moderate and severe asthma in Quebec, Canada

Abstract

OBJECTIVES: Asthma affects nearly one-tenth of the Canadian population. The purpose of these studies was to estimate the direct and indirect costs of asthma in Canada, using data from the Registre de données en Santé Pulmonaire (RESP), Quebec health administration databases, and prospective data from randomly selected patients from the RESP registry.METHODS: A 2-year, retrospective study (Study 1) and a 1-year, prospective study (Study 2) were conducted in patients with asthma. In Study 1, annual, asthma-related direct healthcare utilization per patient and medication costs per patient were determined and stratified by asthma severity and control. In Study 2, indirect costs were estimated for lost work time (absenteeism) and productivity (presenteeism).MEASUREMENTS AND MAIN RESULTS: In Study 1 (N = 331), the annual asthma-related direct cost was CAN$2,018/patient, with medication constituting 91% of the total cost. Annual costs for very severe or uncontrolled asthma were CAN$11,946/patient and CAN$2,884/patient, respectively. In Study 2 (N = 101), the asthma-related annual indirect cost ranged from CAN$373 to CAN$807/patient.CONCLUSIONS: Our studies provide evidence that direct and indirect costs of asthma in Quebec are substantial. Direct costs are mainly related to the cost of medications and are influenced by asthma severity and control. Indirect costs are caused mainly by absenteeism.