ECONOMIC-ANALYSIS OF 2 STRUCTURED TREATMENT AND TEACHING PROGRAMS ON ASTHMA

The aims of the present study were as follows: 1) to evaluate the medi cal outcomes of two treatment and educational asthma programs 2) to de termine by cost-analysis both cost and economic outcome of the program s 3) to perform a cost-benefit analysis (determining the net cost-bene fit) and a cost-effectiveness analysis (determining the cost per unit of effect and the incremental cost-effectiveness ratio) from the persp ective of health program policy makers (HPP; indirect costs, i.e., los s of productivity, excluded) and of society as a whole (SaW; all costs included). Patients were randomly assigned to a complete (CP; n = 32) or reduced (RP; n = 33) program: the RP group received a reduced educ ation (self-reading of an educational booklet on asthma), while the CP group attended an ''asthma school'' consisting of six lessons based o n the same I booklet and including educational videotapes. Both progra ms included peak-flow monitoring and treatment according to internatio nal guidelines, and follow-up. The outcome variables (asthma attacks, urgent medical a examinations, admission days, working days lost) did not differ significantly between CP and RP. Morbidity savings were $18 94.70 (CP) and $1697.80 (RP) according to SaW, and $1349.50 and $1301. 80, respectively, according to HPP. The net cost-benefit was $1181.50 for CP and $1028.00 for RP, and the cost-benefit ratio per dollar spen t was 1:2.6 for CP and 1:2.5 for RP, according to SaW. One day of admi ssion prevented had a cost of $110.20 (CP) and $94.10 (RP). CP gave sl ightly better results and was slightly more cost-effective than KP in improving patients' welfare. It cannot be excluded that the retrospect ive analysis used to determine baseline costs might have inflated diff erences for both groups. Sensitivity analysis was slightly in favor of RP when the outcome variables were tested at their upper and lower 95 % CI.