OBJECTIVES: Prior evidence suggests that the risk of cardiovascular and metabolic disorders may be high among patients with asthma due to common inflammatory pathways. However, real-world observational studies examining the burden of cardiometabolic disorders (CMDs) among patients with asthma are limited. This study examines the prevalence and incremental economic burden of CMDs among patients with asthma in the US.
METHODS: A cross-sectional, retrospective study design using data from alternate multiple years (2008/2010/2012/2014) of the Medical Expenditure Panel Survey was conducted. Adults with asthma were identified using the ICD-9-CM code for asthma (493.xx). Patients with diabetes, endocrine disorders, heart disease, and/or hypertension were considered as having CMDs. Annual healthcare expenditures for hospitalizations, emergency room and outpatient visits, prescription drugs, and other services were assessed. Unadjusted differences in average annual healthcare expenditures between patients with and without CMDs were determined using t-tests. Adjusted ordinary least squares (OLS) regression on log-transformed healthcare expenditures were conducted to estimate the magnitude of excess healthcare expenditures associated with CMDs. All analyses were weighted to control for the complex sample design of MEPS.
RESULTS: The current study sample consisted of adults with asthma (unweighted n=4,862; weighted n=32.6 million), out of which 55.1% had comorbid CMDs. Approximately three times higher total annual expenditures ($15,233 vs $5,888 [P<0.001]) were observed among patients with CMDs compared to those without CMDs. Prescription drugs and outpatient services were major contributors of the increased healthcare expenditures. Adjusted OLS regression revealed that patients with comorbid CMDs had 34% (β=0.293; exp[β]=1.34; P<0.001) higher expenditures than patients without CMDs.
CONCLUSIONS: Findings from the current study highlight the elevated prevalence and increased economic burden of CMDs among adults with asthma. Further research to elucidate the reasons behind increased healthcare expenditures is needed to better guide the management of chronic conditions among patients with asthma.
