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Original Article


Costs Associated With Workdays Lost and Utilization of Health Care Resources Because of Asthma in Daily Clinical Practice in Spain


P Ojeda,1 V Sanz de Burgoa,2 on behalf of the investigators of the Coste Asma Study

1Clínica de Asma y Alergia Dres. Ojeda, Madrid, Spain
2Medical Department, Pfizer SLU, Alcobendas, Spain

J Investig Allergol Clin Immunol 2013; Vol. 23(4): 234-241



Asthma is associated with high indirect costs due to lower work productivity and higher absenteeism and presenteeism.

Objectives: To study loss of productivity measured using the lost workday equivalent (LWDE) index and health care utilization in asthmatics depending on age, geographical location, time period, severity, and level of asthma control. Patients and Methods: In this cross-sectional, observational, epidemiological multicenter study, 120 allergists nationwide were asked to select asthmatic patients aged 18 to 65 years who were evenly distributed according to the 4 levels of asthma severity (Global Initiative on Asthma) during 3 different seasons. The participants collected sociodemographic data, spirometry values, Asthma Control Test (ACT) score, health care utilization data, perceived stress according to the Impact on Work Productivity Index (IMPALA, Índice del Impacto de la Enfermedad en la Productividad Laboral), and score on the Sheehan disability scale. The LWDE index was used to measure the number of workdays lost and the number of workdays with asthma symptoms combined with the percentage for average performance at work.

Results: The study sample comprised 1098 patients (58.7% females; 48.5% aged 18-40 and 51.5% aged 41-65). According to the ACT score, disease was uncontrolled in 57.6% of patients, well controlled in 32.8%, and totally controlled in 9.6%. The mean cost due to
workdays lost was €285.81/patient/mo (95%CI, €252.71-318.92). Indirect costs were significantly higher in older patients (41-65 years, €405.08; 95%CI, 348.97-461.19), patients with more severe disease (€698.95; 95%CI, €588.63-809.27), and patients with more poorly controlled asthma (€466.86; 95%CI, €414.39-519.33).
The average cost of health care units per patient for each 3-month period was €1317.30 (95%CI, €1151.34-€1483.26). Indirect costs were significantly higher in older patients (€2104.00 in patients aged 18-40 vs €3301.55 in patients aged 41-65), in northern and
central regions, in severe disease (€2921.63), and in more poorly controlled asthma (€1799.42).

Conclusion: Our findings could prove useful for physicians and health care providers.

Key words: Asthma costs. Health care utilization. LWDE. Absenteeism. Presenteeism. ACT (Asthma Control Test). IMPALA (Impact on Work Productivity).