IS ASTHMA SELF-MANAGEMENT COST-EFFECTIVE

Many clinical studies have shown that self-management and educational programs in asthma are effective. However, these programs are costly t hemselves and could also lead to higher drug costs due to higher rates of compliance. On the other hand, if better usage of available treatm ent leads to better asthma control, the patients' utilization of other health care resources and absence from work might be reduced. An inte resting question is therefore whether the self-management and educatio nal programs in asthma have been cost-effective. This study holds a re view of the evidence of cost-effectiveness of self-management and educ ational programs in asthma. Several methodological flaws were detected (for example, a common effectiveness variable is lacking in the liter ature) and suggestions of improvements were given. The overall picture is, however, that self-management and educational programs in asthma are cost-effective interventions, both for children and for adults. As would be expected, it also seems as if programs directed at high risk groups and patients with severe asthma are even more cost-effective. Costs for absence from work were often excluded, which could lead to f urther societal savings. Also, some studies showed that the effect of the self-management and educational programs had effects even after th e initial year. Since most studies only covered the initial year of tr eatment, the cost-effectiveness of self-management and educational pro grams in asthma is likely to be underestimated in the reported studies . (C) 1997 Elsevier Science Ireland Ltd.