PRS19 Quality of Life and Economics of Asthma Control in France and Spain: Final Results of the EU-Coast Study

Abstract

Current asthma management guidelines are based on the level of asthma control. This study was designed to estimate quality of life and health care costs according to the patients' level of asthma control in France and in Spain in real-life setting. On a 1-month and a 3-months period. An observational retrospective bottom-up cost of illness study (XX2113553) was conducted simultaneously in both countries among adults with asthma. Patients were recruited by samples of general practitioners during four quarterly waves throughout the year 2010 avoiding thus a seasonal bias. Asthma control was evaluated using the auto-test Asthma Control Test (ACTTM) for a one month period and 2009 GINA's asthma control criteria for a three months period. Quality of life (QoL) was assessed using EQ-5D profile. Costs (direct and indirect) were evaluated from a societal perspective. A total of 2671 patients (France: 1154; Spain: 1517) were enrolled in the survey. Asthma was determined to be well-controlled (ACT ≥ 20) in 54.2% [IC 95%: 50.9% - 57.7%] and 58.8% [IC95: 56.2% - 61.3%] of French and Spanish patients respectively. In both countries, average EQ-5D scores were higher for patients with well-controlled asthma (France: 0.9 vs. 0.7, p<0.0001; Spain: 0.9 vs. 0.6, p<0.0001). Total costs of asthma varied accordingly to asthma control in both countries. The average total cost (Euros/month/patient) of well-controlled asthma was 57 € (±467) in France and 82 € (±171) in Spain compared with 111 € (±618) (p<0.0001) and 221 € (±323) (p <0.0001) respectively for not well-controlled asthma. Similar variations were observed using the GINA's criteria on a 3-months period. Results suggested that a poor asthma control is associated with higher costs and lower QoL in patients with asthma in both countries. Improving the control of asthma could eventually be associated to a decrease of the burden of asthma.