Cost-benefit impact of free asthma medication provision for the pediatric population

• Published in: Respiratory medicine Vol. 164; p. 105915
• Main Authors: Koltermann, Vanessa, Friedrich, Frederico Orlando, Fensterseifer, Ana Carolina, Ongaratto, Renata, Pinto, Leonardo Araújo
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2020; Elsevier Limited
• Subjects: Access to information; Age groups; Asthma; Asthma admissions; Children; Chronic illnesses; Confidence intervals; Corticosteroids; Cost benefit analysis; Cost control; Cost estimates; Costs; Epidemiology; Health care; Hospitals; Information technology; Inhaled corticosteroids; Morbidity; Mortality; Patient admissions; Pediatrics; Population; Population studies; Public health; Public health care systems; Respiratory diseases; Brazil; United States > US; Costs; Inhaled corticosteroids; Public health care systems; Asthma admissions
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2020.105915

Asthma is a common chronic disease in childhood, resulting in high costs for health care systems and society. As of June 2011, the Brazilian Unified Health System (SUS) provides free asthma medications for the population. This study evaluated the impact of this program on asthma admissions in the population aged 1–19 years. In addition, a cost-benefit analysis compared data before and after the introduction of the program. This descriptive study was based on information from SUS Information Technology Department (DATASUS). Admission rates and costs of patients aged 1–19 years with diagnosed asthma were compared before (2008–2010) and after (2012–2017) the provision of free inhaled corticosteroid. The asthma admission rate reduced by 28.4% when comparing the two periods (OR 0.71; 95% CI 0.64–0.79). Children aged 1–4 years had a 27.3% reduction in asthma admissions (OR 0.72; 95% CI 0.63–0.82), while those aged 15–19 years had a 39.65% decrease (OR 0.59; 95% CI 0.37–0.95). Asthma admission costs decreased when comparing the two periods (OR 0.68; 95% CI 0.62–0.74). After the introduction of the program, mean cost savings reached US $27,865,905.08 in children aged 1–4 years and US $21,350,660.63 in those aged 5–19 years. The economic burden of pediatric asthma on Brazil's public health care system is significant. From 2012 to 2015, free provision of inhaled corticosteroid was cost-effective in all age groups. In 2017, no cost-benefit effect was observed in this population, but asthma admission rate decreased. •Pediatric asthma imposes a significant economic burden on health care systems.•Brazilin public health system provides free asthma medications for the population.•The asthma admission rate and costs decreased after the introduction of the program.•Free provision of inhaled corticosteroid was cost-effective in all age group.