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Asthma control and its direct healthcare costs: findings using a derived Asthma Control Test^TM score in eight Asia-Pacific areas

C. K. W. Lai^*, S-H. Kuo^#, T. de Guia^||, A. Lloyd, A. E. Williams and M. D. Spencer

^* Dept of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, ^# National Taiwan University Hospital, Taipei, Taiwan, ^|| Philippine Heart Centre, Quezon City, The Philippines, Fourth Hurdle Consulting Ltd, London, and GlaxoSmithKine R&D, Greenford, UK.

CORRESPONDENCE: C. K. W. Lai, Room 1403, Takshing House, 20 Des Voeux Road Central, Hong Kong. Fax: 852 25222188. E-mail: keilai{at}netvigator.com

The present authors explored the relationship between asthma control status, measured using a derived Asthma Control Test^TM (ACT) score, and utilisation of healthcare and its cost in eight Asia-Pacific areas.

Patients were included if they were aged 12 yrs and had participated in a recent survey of asthma patients. Patient-reported frequency of healthcare resource use was used to estimate the cost of asthma care. The ACT score was derived from survey questions identical or similar to the items comprising the ACT.

An ACT score was derived for 2,062 patients, of whom 59% (1,220) scored <20, suggesting that their asthma was not well controlled, and with 21% (423) scoring <15, suggesting poorly controlled asthma. The mean per-patient annual cost of asthma management for patients with a derived ACT of <15 was US$861 (95% confidence interval: US$686–1,042); US$319 (US$286–357) for patients with a derived ACT score of 15–19, and US$193 (US$173–214) for patients with a derived ACT score of 20. A higher derived ACT score was associated with significantly lower annual expenditure on asthma management.

Poorer asthma control was associated with an increased frequency of all unscheduled healthcare and elevated cost. This finding was consistent across a range of Asia-Pacific areas.

KEYWORDS: Asia Pacific, asthma, asthma control test, healthcare costs