Clinical Burden and Healthcare Resource Use of Asthma in Children in the UK.

Abstract

Background: UK pediatric asthma prevalence is among the highest in Europe, and although the clinical and economic burden of asthma in UK adults is well described, childhood asthma data is lacking. We assessed the clinical and economic burden of asthma in children in the UK to better understand the impact of pediatric asthma.

Methods: This was a retrospective, case-matched, longitudinal analysis using the Clinical Practice Research Datalink GOLD database and linked patient-level data (Hospital Episode Statistics and Office for National Statistics datasets) of selected patient (aged 6-11 years) records in 2017. Severe exacerbation and re-exacerbation rates per patient-year (PPY), all-cause healthcare resource utilization (HCRU), and HCRU-related costs were assessed in asthma patients versus matched non-asthma controls, stratified by severity.

Results: Among 5950 patients, severe exacerbation rate was 0.06, 0.17 and 0.31 PPY for mild, moderate, and severe asthma, respectively. Incident rate of severe exacerbations were higher for moderate asthma (incident rate ratios [IRR; 95% CI] 2.87 [2.30-3.56], P<0.0001) and severe asthma (5.19 [4.20-6.41], P<0.0001) versus mild asthma. Risk of re-exacerbation was significantly increased for severe versus mild asthma (hazard ratio [95% CI]: 2.98 [1.90-4.65], P<0.001). All-cause HCRU (IRR [95% CI]) was higher in severe asthma patients versus controls (primary care: 3.81 [3.54-4.09], P<0.0001; inpatient admissions: 3.23 [2.31-4.62], P<0.0001]); total-cost ratios relative to controls for mild, moderate, and severe asthma were 1.58 (1.39-1.78, P<0.0001), 2.56 (1.97-3.33, P<0.0001), and 3.42 (2.54-4.61, P<0.0001), respectively. Asthma-related costs increased with severity (total-cost ratios: moderate versus mild, 1.68 [1.45-1.97], P<0.0001; severe versus mild, 2.67 [2.21-3.25], P<0.0001).

Conclusion: In children with asthma in the UK, increasing disease severity was associated with increased risk of severe exacerbations, re-exacerbations, and increased HCRU and costs.