Clinical Benefits and Cost Reduction Associated with a Comprehensive Asthma Management Programme at a Managed Care Organisation

The necessity of having reliable measurements of patient care and cost parameters is becoming more recognised in medicine today. This is particularly true for chronic, high cost diseases such as asthma. The goal of this asthma disease management programme was to determine whether the implementation of a health management programme designed to promote stricter adherence to components of the National Heart, Lung, and Blood Institute guidelines for asthma would result in a reduction in the occurrence of acute asthma events and a lower total cost of treatment. The study took place in the member population of a large managed care organisation (MCO). Measurements of programme effects were compared with a preceding baseline year using data from reimbursement claims to determine outcomes. The percentage of patients requiring inpatient hospitalisation significantly decreased, from 5.6 to 4.63% (p < 0.01) and emergency room visits also decreased, from 18.1 to 17.8%. It was found that promoting closer adherence to the treatment guidelines significantly increased the appropriate use of anti-inflammatory agents for treatment of the underlying disease process (p < 0.001). As might be expected, the greater use of medications resulted in an increase in pharmacy costs; however, for every additional $US1.00 spent on pharmacy, the MCO saved $US1.31 in nonpharmacy medical costs. The total medical costs associated with the management of asthma decreased. A comprehensive asthma management programme can reduce both the occurrence of acute asthma events and reduce the cost of treatment on a population basis when asthma treatment guidelines are reinforced.