The individual and health sector costs of asthma: The first year of a longitudinal study in New South Wales

Objective: To identify the resources used and the costs incurred by people with asthma for health care and non-health care products and services to manage asthma. Methods: A prospective, longitudinal study, using self-reported and administrative data, commenced in 2001 in New South Wales (NSW). Data sources included two six-monthly surveys, hospital admission data from NSW Health, and pharmaceutical benefits and Medicare data. A cohort of 245 people with asthma, aged between 5-75 years, was recruited from the general population and from hospital emergency departments. The study measured the use and cost of health care services and products, including alternative therapies and home modifications. Costs to both the health care system and individuals were measured. Results: General practitioner visits and asthma medications were the items of health care most commonly used. Medications were also the largest component of individual costs for health care in terms of the average payment and the number of people facing an out-of-pocket cost, although home equipment and modifications were the most expensive individual items. The distribution of individual costs was highly skewed, ranging from $0 to $4,882 per person per annum (median $89). Admitted hospital care was the largest component of the cost to the health care system. Conclusion: While individual costs were not large for the majority, some people faced substantial costs, with the highest of these being for non-health care items. Implications: Asthma management policies may need to incorporate schemes to alleviate the impact of costs for the minority experiencing significant out-of-pocket expenses.