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J Allergy Clin Immunol Pract. 2019 May - Jun;7(5):1477-1487. doi: 10.1016/j.jaip.2018.12.029. Epub 2019 Jan 25.

The Burden of Severe Asthma in France: A Case-Control Study Using a Medical Claims Database.

Author information

1
Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Montpellier, France; PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Montpellier, France.
2
AstraZeneca, Courbevoie, France.
3
Real World Evidence, CEMKA, Bourg La Reine, France. Electronic address: Stephane.bouee@cemka.fr.
4
Real World Evidence, CEMKA, Bourg La Reine, France.
5
INSERM UMS 011, Villejuif, France.
6
Service de Pneumologie, CHI Créteil, Créteil, France.

Abstract

BACKGROUND:

Severe asthma (SA) is defined by treatment intensity. The availability of national databases allows accurate estimation of the prevalence, long-term outcomes, and costs of SA.

OBJECTIVE:

To provide accurate information on SA, focusing on comorbidities, mortality, health care resource consumption, and associated costs.

METHODS:

A cohort of patients with SA identified in 2012 was extracted from a French representative claims database and followed for 3 years. Their characteristics, comorbidities, mortality, and direct costs were compared with a matched control group without asthma.

RESULTS:

A total of 690 patients with SA were matched to 2070 patients without asthma (mean age, 61 years; 65.7% women). The prevalence of SA was estimated to be 0.18% to 0.51% of the French adult population. Comorbidities were more frequent in patients with SA (73.9% suffered from cardiovascular disease vs 54.3% in controls; P < .001). A total of 58.7% of patients with SA used oral corticosteroids (OCS) in 2012 with a mean intake of 3.3 boxes/year/patient and 9% received ≥6 dispensings of OCS. A total of 6.7% were treated by omalizumab. Patients with SA were more frequently hospitalized (33.2% vs 19.7%; P < .001), more frequently consulted a general practitioner (97.8% vs 83.9%; P < .001) (9.8 ± 6.8 vs 6.2 ± 5.3 consultations/year; P < .001), and 31% have consulted a private respiratory physician. Compared with controls, 3-year cumulative mortality was higher in SA (7.1% vs 4.5%; P = .007). Direct medical cost was $9227 versus $3950 (P < .001) mostly driven by medication costs.

CONCLUSIONS:

The prevalence of SA in the French adult population is at least 18 of 10,000. Burden of disease is high with respect to comorbidities, mortality, and asthma-related health care resource use.

KEYWORDS:

Comorbidities; Costs; France; Mortality; Prevalence; Severe asthma; Treatment

PMID:
30685573
DOI:
10.1016/j.jaip.2018.12.029

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