asthma intervention cost effective for us inner-city children

PharmacoEconomics & Outcomes News 392 - 7 Dec 2002 Asthma intervention cost effective for US inner-city children A multifaceted, social worker-based intervention for inner-city children with asthma is cost effective in the US, and is cost saving among those with severe disease, report researchers from that country. They prospectively assessed direct costs and outcomes among 1033 children with asthma (aged 5–11 years) who were enrolled in the multicentre National Cooperative Inner-City Asthma Study, over a 2-year period. * Children were randomised to a 12-month family programme with environmental control and trained social workers as asthma counsellors, or to usual care. The mean number of asthma symptom-free days improved significantly for the intervention, compared with the usual care, group, over the 2-year period (565.1 vs 538.5 days) at an additional cost of $US245 per child; ** no statistically significant differences were observed in the use of medical care. Compared with usual care, the incremental cost effectiveness ratio of the intervention was $US9.20 per symptom-free day gained. Sensitivity analyses revealed the results to be sensitive to the mean cost associated with the intervention, which would have to be less than $US92 per child to be cost saving, on average. ‘Importantly, in the subgroups of children with more severe asthma, the intervention was substantially more effective and reduced the total cost of medical care’, the researchers note. * The study was supported in part by a research grant from GlaxoSmithKline. ** Costs (1995 values) were those related to the intervention, hospitalisation, emergency-department and clinic visits, and asthma- control devices, and were calculated from a Medicaid payer perspective. Costs and benefits were discounted at 3% during the second year. Sullivan SD, et al. The cost-effectiveness of an inner-city asthma intervention for children. Journal of Allergy and Clinical Immunology 110: 576-581, Oct 2002 800926148 1 PharmacoEconomics & Outcomes News 7 Dec 2002 No. 392 1173-5503/10/0392-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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PharmacoEconomics & Outcomes News 392 - 7 Dec 2002

Asthma intervention cost effectivefor US inner-city children

A multifaceted, social worker-based intervention forinner-city children with asthma is cost effective in theUS, and is cost saving among those with severe disease,report researchers from that country.

They prospectively assessed direct costs andoutcomes among 1033 children with asthma (aged 5–11years) who were enrolled in the multicentre NationalCooperative Inner-City Asthma Study, over a 2-yearperiod.* Children were randomised to a 12-monthfamily programme with environmental control andtrained social workers as asthma counsellors, or to usualcare. The mean number of asthma symptom-free daysimproved significantly for the intervention, comparedwith the usual care, group, over the 2-year period (565.1vs 538.5 days) at an additional cost of $US245 perchild;** no statistically significant differences wereobserved in the use of medical care. Compared withusual care, the incremental cost effectiveness ratio of theintervention was $US9.20 per symptom-free daygained.

Sensitivity analyses revealed the results to be sensitiveto the mean cost associated with the intervention, whichwould have to be less than $US92 per child to be costsaving, on average. ‘Importantly, in the subgroups ofchildren with more severe asthma, the intervention wassubstantially more effective and reduced the total cost ofmedical care’, the researchers note.* The study was supported in part by a research grant fromGlaxoSmithKline.** Costs (1995 values) were those related to the intervention,hospitalisation, emergency-department and clinic visits, and asthma-control devices, and were calculated from a Medicaid payerperspective. Costs and benefits were discounted at 3% during thesecond year.

Sullivan SD, et al. The cost-effectiveness of an inner-city asthma intervention forchildren. Journal of Allergy and Clinical Immunology 110: 576-581, Oct2002 800926148

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