Direct and indirect costs of asthma in Canada, 1990

Objective: To calculate the direct and indirect costs of asthma in Canada. Design: Cost-of-illness study. Setting: Canada. Patients: All Canadians receiving inpatient or outpatient care for asthma in 1990. Outcome measures: Direct costs incurred by inpatient care, emergency services, physician and nursing services, ambulance use, drugs and devices, outpatient diagnostic tests, research and education. Indirect costs from productivity loss due to absence from work, inability to perform housekeeping activities, need to care for children with asthma who were absent from school, time spent travelling and waiting for medical care, and premature death from asthma. All costs are in 1990 Canadian dollars. Results: Depending on assumptions, the total cost of asthma was estimated to be between $504 million and $648 million. Direct costs were $306 million. The single largest component of direct costs was the test of drugs ($124 million). The largest component of indirect costs was illness-related disability ($76 million). Conclusions: Annual costs of treating asthma are comparable to the individual cost of infectious diseases, hematologic diseases, congenital defects, perinatal illnesses, home care and ambulance services. Asthma costs may increase in the future, given current morbidity and mortality trends. Further evaluation of the effectiveness and cost-effectiveness of available asthma interventions in addition to aggregate cost data are required to determine whether resource allocation for the treatment of asthma can be improved.