Cost implications for the use of inhaled anti-inflammatory medications in the treatment of asthma

Objective: To compare the expected costs of treating patients with asthma w ith versus without inhaled anti-inflammatory medications, adjusting for oth er factors that also influence medical care expenditures. Design: Nonlinear exponential regression analyses were used to estimate rel ationships between medical care expenditures and treatment with inhaled cor ticosteroids, sodium cromoglycate (cromolyn) or nedocromil. The regressions adjusted for differences in patients' demographics, location, plan type an d severity of illness. Setting: Large, self-insured, corporate-sponsored medical plans represented in MarketScan database. Patients and Participants: 7466 continuously enrolled patients with asthma. Interventions: Treatment with inhaled corticosteroids, sodium cromoglycate or nedocromil. Main Outcome Measures: (i) Total inpatient, outpatient and pharmaceutical e xpenditures; and (ii) asthma-related expenditures in the 1996 calendar year . Results: If all patients had been treated with inhaled anti-inflammatory dr ugs, total expenditures would be expected to be about $US944.82 per patient lower on average, than would be the case if no patients received these dru gs. Asthma-related expenditures would be about $US498.74 per patient higher , on average, if all patients were treated with these drugs. Conclusions: Using inhaled anti-inflammatory agents would be associated wit h higher asthma-related expenditures but lower total expenditures. Treatmen t with inhaled anti-inflammatory drugs may represent an investment in bette r care that pays off with better health and lower total medical care expend itures.