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ICD Code: 493. Asthma



ICD Code: 493. Article Review
Title: Sarpong EM et al; "Changes in Children's Use and Expenditures for Asthma Medications, United States, 1997-1998 to 2007-2008." Medical Expenditure Panel Survey; Statistical Brief No.341; 9/11; p1
      STUDY DESIGN: This Statistical Brief examines changes in asthma medication use and expenditures among children with reported treatment for asthma from 1997-1998 to 2007-2008 using data from the Household Component of the Medical Expenditure Panel Survey (MEPS-HC). MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the U.S. civilian noninstitutionalized population. The authors present results on the treated prevalence of asthma; the use of controllers, relievers, oral corticosteroids and specific classes of controller medications; and total and out-of-pocket drug expenditures. Expenditures for asthma medications for all years are expressed in constant 2008 U.S. dollars.
      TREATMENT TRENDS: Overall, the average annual proportion of children with reported treatment for asthma in the U.S. increased from 4.7% in 1997-1998 to 6.1% in 2007-2008. There were increases in the treated prevalence of asthma for children ages 5-11 (5.2% to 7.5%) and ages 12-17 (4.0% to 5.7%).
      The average annual proportion of children with reported treatment for asthma who used controllers to treat their asthma nearly doubled from 29.4% in 1997-1998 to 58.3% in 2007-2008. During the same period, the average annual proportion using relievers, but not controllers, fell from 43.8% to 30.4%, and the average annual proportion using oral corticosteroids decreased from 17.1% to 8.7%.
      There were also increases in the use of several specific classes of controller asthma medications during the period of analysis. The average annual proportion of children with reported treatment for asthma who used inhaled corticosteroids increased from 15.5% to 40.3%; the average annual proportion using inhaled long acting beta-agonists increased from 3.0% to 13.2%; and the average annual proportion using leukotriene antagonists, rose from 2.9% to 34.1%. The use of non-steroidal anti-allergy agents declined during the period of analysis from 15.1% to 0.6%.
      EXPENDITURES: Average annual total expenditures on all prescribed asthma medications by children with reported treatment for asthma more than quadrupled, from $527 million in 1997-1998 to $2.5 billion in 2007-2008 after adjustment for inflation. During the same period, average annual total expenditures on controller medications increased 7-fold from $280 million to $2.1 billion, and average annual total expenditures on relievers jumped 58.9% from $222 to $352 million. Average annual total expenditures on oral corticosteroids, however, decreased 68.0% from $25 to $8 million. Average annual total expenditures on controllers were 6 times the corresponding expenditures for relievers and more than 260 times the average annual total expenditures for oral corticosteroids in 2007-2008.
      Average annual expenditures per user on all prescribed asthma medications by children with reported treatment for asthma nearly tripled from $207 in 1997-1998 to $605 in 2007-2008. During the same period, average annual expenditures per user on asthma controller medications nearly tripled from $282 to $796, about 40 times the expenditure per user on oral corticosteroids, which fell 53.9% from $44 to $20. Average annual expenditures per user on relievers averaged $112 in 2007-2008, representing 14.1% of the average annual expenditure per user on controllers in 2007-2008.
      Average annual out-of-pocket expenditures per user on all prescribed asthma medications by children with reported treatment for asthma nearly doubled from $65 in 1997-1998 to $123 in 2007-2008. Average annual out-of-pocket expenditures per user on controller asthma medications nearly doubled from $77 to $153. During the same period, average annual out-of-pocket expenditures per user on oral corticosteroids asthma medications decreased 52.4% from $21 to $10. In 2007-2008 average annual out-of-pocket expenditures per user on controllers were 5 times the annual average of $30 for relievers and 15 times the annual average of $10 for oral corticosteroids.

Search Criteria: Text - Medical Expenditure Panel Survey; Statistical Brief No.341; 9/11; p1