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Introduction
In 1994*, asthma affected an estimated 14.2 million Americans*, and cost the U.S. economy an estimated $10.7 billion.*
*(These data have been updated to reflect a current estimated asthma prevalence of 20 million Americans, and an estimated total cost of $18.3 billion, including $10.1 billion in direct costs -- medicines and healthcare services -- and $8.2 billion in indirect costs -- lost productivity due to missed days at school or work.)
The Asthma and Allergy Foundation of America and the researchers who developed these cost estimates believe these findings present a compelling case for access to better care and utilization of treatment guidelines, early intervention to prevent "crisis" care, and intensified research into the disease.
Summary of 1994 Findings
Indirect costs of asthma in 1994: $4.64 billion. Indirect costs associated with asthma - workdays lost, time lost from school and costs attributed to asthma deaths - rose far more sharply in real dollars between 1985 and 1994 than did direct medical expenses. Indirect costs went from nearly $2 billion in adjusted 1985 dollars to $4.64 billion in 1994, a 133 percent increase.
Costs associated with time adults lost from work because of their own asthma quadrupled over the last 10 years, representing the steepest rise in indirect costs. Lost work time costs for caregivers of people with asthma- typically parents who stayed home when their children were too sick to go to school-- increased 88 percent. Premature death of people with asthma, which rose 41.4 percent between 1985 and 1994, caused costs associated with asthma mortality to increase 151 percent.
Direct medical costs for asthma care in 1994: $6 billion. Direct medical expenditures (or DME, which includes hospitalizations, doctors' visits and medications) were nearly $5 billion in 1985 and just over $6 billion in 1994. By far, medication expenditures were, in 1994, the largest component cost of DME at 40.1 percent - up from 30 percent in 1985. Indeed, between 1994 and 1985, the total number of prescriptions for asthma rose by 103.2 percent and total expenditures for asthma medications increased from $1.4 billion in 1985-adjusted dollars to about $2.5 billion in 1994.
The prevalence of asthma has been increasing since the early 1980s across all age, sex and racial groups. However, the prevalence of asthma is higher among children than adults, and higher among blacks than whites.
Given the current data available on asthma, researchers were able to breakdown the costs of asthma by age (see chart below). For further explanation on how researchers arrived at these estimates, see the Methodology.
Tables of 1998 Findings
|
Estimated Prevalence
|
Persons with
asthma
|
Direct Medical Expenditures
|
Indirect
Costs
|
Total
Costs
|
| All |
5.44 |
14.16 |
6,107.6 |
4,640.6 |
10,748.3 |
| 17 or Under |
7.34 |
4.98 |
1,958.2 |
1,215.5 |
3,173.7 |
| 18 or Over |
4.77 |
9.18 |
4,149.4 |
3,425.1 |
7,574.5 |
The study, "Trends in the costs of asthma in the United States, 1985-1994," appears in the September issue of the Journal of Allergy and Clinical Immunology. Research for the study was conducted by Kevin B. Weiss, M.D., Rush Primary Care Institute, Chicago; Sean D. Sullivan, Ph.D., University of Washington, Seattle, and Christopher S. Lyttle, M.A., Rush Primary Care Institute, Chicago
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