Published online: September 15, 2020
Asthma is a highly prevalent chronic condition in children under 18 years old in the US and is associated with considerable healthcare costs and emergency department visits. In these patients, worse asthma severity and disease control contribute to increased healthcare costs. Allergic asthma, defined by immune sensitization to environmental allergens, is present in 2/3 of children with persistent asthma. Some studies have associated allergic asthma with increased asthma-related hospitalizations, office visits, and healthcare costs compared with non-allergic asthma; however, no such studies have examined the impact of allergic asthma on healthcare use and costs in school-aged children in the US.
In a recent publication in The Journal of Allergy and Clinical Immunology: In Practice, Teague and his colleagues investigated the impact of allergic sensitization on the rate of asthma exacerbations; the use of oral corticosteroids; unscheduled use of health care facilities, including hospitalizations and emergency departments; and the economic burden of disease in children with severe or poorly controlled asthma with either private or public health insurance. Data for the present analysis came from the IBM Watson Health MarketScan® databases and included 595,186 privately-insured children and 322,805 Medicaid-insured children with asthma aged 6–11 years.
The results of the analysis show that children with severe, poorly-controlled asthma with allergic sensitization have, on average, greater associated healthcare costs, higher rates of asthma-related hospitalizations and emergency department visits, and more frequent oral corticosteroid use when compared to those children without allergic sensitization. The excess burden of disease attributed to allergic sensitization is in addition to that already imposed by severe, poorly-controlled asthma. Further, the trend of greater costs and utilization in patients with allergic sensitization was observed regardless of insurance type (private vs Medicaid), though at different magnitudes. We therefore recommend that clinicians be mindful of the impact of allergic sensitization in children with asthma, and that those with persistent asthma undergo allergy testing to recognize specific triggers and thereby inform disease management.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.