Abstract
Objective
To estimate the cost of paediatric asthma from a UK National Health
Service (NHS) and societal perspective and explore determinants of these
costs.
Design
Cost analysis based on data from a large clinical trial between 2017
and 2019. Case report forms recorded healthcare resource use and
productivity losses attributable to asthma over a 12-month period. These
were combined with national unit cost data to generate estimates of
health service and indirect costs.
Setting
Asthma clinics in primary and secondary care in England and
Scotland.
Main outcome measures
Cost per asthma attack stratified by highest level of care received.
Total annual health service and indirect costs. Modelled effect of sex,
age, severity, number of attacks and adherence on total annual
costs.
Results
Of 506 children included in the analysis, 252 experienced at least
one attack. The mean (SD) cost per attack was £297 (806) (median £46,
IQR 40–138) and the mean total annual cost to the NHS was £1086 (2504)
(median £462, IQR 296–731). On average, children missed 6 days of school
and their carers missed 13 hours of paid work, contributing to a mean
annual indirect cost of £412 (879) (median £30, IQR 0–477). Health
service costs increased significantly with number of attacks and
participant age (>11 years). Indirect costs increased with asthma
severity and number of attacks but were found to be lower in older
children.
Conclusions
Paediatric asthma imparts a significant economic burden on the
health service, families and society. Efforts to improve asthma control
may generate significant cost savings.
Trial registration number
ISRCTN 67875351.
Funder
National
Institute for Health and Care
Research