Environmental, healthcare, and societal impacts of asthma: a UK model-based assessment

Abstract

BackgroundThis study aimed to assess the broader environmental, healthcare, and societal impacts across the entire asthma pathway from diagnosis to treatment, in the United Kingdom (UK).MethodsA comprehensive cost-of-Illness framework was developed considering the effects of the full asthma patient pathway, including greenhouse gas (GHG) emissions generated from inhalers, National Health Service (NHS) costs, health-related quality of life (HRQoL), and productivity losses. The model was based on published literature and clinical expert opinion to accurately estimate, in monetary terms, the net present value (NPV) of the asthma pathway impacts for 2022–31.ResultsThe estimated NPV of the environmental, healthcare, and societal impacts of the asthma pathway was £47 billion over the 2022–31 period in the UK. Loss of disease control was a key contributor to higher GHG emissions and NHS costs. In 2022, a non-severe uncontrolled patient was estimated to incur 22% higher NHS costs than a controlled patient, whilst generating 0.1 tonnes (t) more of CO2equivalent (CO2e) emissions. In the same year, the total direct impacts per severe patient was four times higher than a non-severe controlled patient, with 0.54t CO2e of GHG emissions. Moreover, as much as 77% of the total economic impact was driven from HRQoL worsening and productivity impacts occurring when patients’ symptoms are uncontrolled.ConclusionsUncontrolled asthma significantly impacts the economy, environment, and patients in the UK. Hence, our results emphasize the need for a holistic approach in controlling asthma and might be carefully considered when developing policies to mitigate the overall burden of the disease.