DIRECT AND INDIRECT COSTS OF ASTHMA IN CANADA, 1990

Objective: To calculate the direct and indirect costs of asthma in Can ada. Design: Cost-of-illness study. Setting: Canada. Patients: All Can adians receiving inpatient or outpatient care for asthma in 1990. Outc ome measures: Direct costs incurred by inpatient care, emergency servi ces, physician and nursing services, ambulance use, drugs and devices, outpatient diagnostic tests, research and education. Indirect costs f rom productivity loss due to absence from work, inability to perform h ousekeeping activities, need to care for children with asthma who were absent from school, time spent travelling and waiting for medical car e, and premature death from asthma. All costs are in 1990 Canadian dol lars. Results: Depending on assumptions, the total cost of asthma was estimated to be between $504 million and $648 million. Direct costs we re $306 million. The single largest component of direct costs was the test of drugs ($124 million). The largest component of indirect costs was illness-related disability ($76 million). Conclusions: Annual cost s of treating asthma are comparable to the individual cost of infectio us diseases, hematologic diseases, congenital defects, perinatal illne sses, home care and ambulance services. Asthma costs may increase in t he future, given current morbidity and mortality trends. Further evalu ation of the effectiveness and cost-effectiveness of available asthma interventions in addition to aggregate cost data are required to deter mine whether resource allocation for the treatment of asthma can be im proved.