ASSESSING COST-EFFECTIVENESS IN ASTHMA CARE - BUILDING AN ECONOMIC-MODEL TO STUDY THE IMPACT OF ALTERNATIVE INTERVENTION STRATEGIES

Expenditures for medical care services continue to rise as a proportio n of the total Gross Domestic Product (GDP) in most countries. Because a large share of resources are increasingly being spent on medical ca re services, there is a need to more closely examine the quality, cost and efficiency of all aspects of health care delivery. One method for assessing efficiency is cost-effectiveness analysis. Many of the elem ents of a basic cost-effectiveness model for asthma care are available , including accepted relevant studies on societal cost-of-illness, acc epted health outcomes relevant to good clinical care, and a selection of potential intervention strategies, both for prevention and control. The purpose of this paper is to illustrate how an economic approach t o decision-making can be used to assess the potential impact of altern ative intervention strategies for asthma care. Two case studies are de veloped including a new management strategy for the chronic care of st able moderate asthma and a management strategy for the early detection and prevention of childhood asthma. It is proposed that economic mode ling of possible intervention strategies can serve as a useful method for determining the potential impact (in terms of cost-effectiveness) of a proposed intervention strategy well in advance of any empiric cli nical trials. Analysis such as these may prove valuable in protecting researchers from developing intervention strategies that are clinicall y efficacious but cost-ineffective and, therefore, are unlikely to be adopted by providers/payers of medical care services for asthmatics.