Shadow cost of oral corticosteroids-related adverse events: A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry

SANI Network, Giorgio Walter Canonica, Giorgio Lorenzo Colombo, Giacomo Matteo Bruno, Sergio Di Matteo, Chiara Martinotti, Francesco Blasi, Caterina Bucca, Nunzio Crimi, Pierluigi Paggiaro, Girolamo Pelaia, Giovanni Passalaqua, Gianenrico Senna, Enrico Heffler

Research output: Contribution to journalArticle

Abstract

Background: Asthma is one of the most common non-communicable respiratory diseases, affecting about 6% of the general population. Severe asthma, even if afflicts a minority of asthmatics, drives the majority of costs of the disease. The aim of this study is to create a pharmacoeconomic model to predict the costs of corticosteroid-related adverse events in severe asthmatics and applying it to the first published epidemiologic data from the Severe Asthma Network in Italy (SANI) registry. Methods: The analysis was conducted from the perspective of the Italian National Healthcare System (INHS). Model inputs, derived from literature, included: asthma epidemiology data, frequency of adverse events, percentage of severe asthma treated with OCS and adverse event cost (Diagnosis-Related Group (DRG) national tariffs). We estimated costs per different patient groups: non-asthma controls, mild/moderate and severe asthmatics. Final results report estimated direct cost per patient and total direct cost for overall target population, showing economic impact related to corticosteroid complication. Results: Based on epidemiological data input, in Italy, asthmatic subjects resulted about 3,999,600, of which 199,980 with severe asthma. The number of patients with severe asthma OCS-treated was estimated at 123,988. Compared to the non-asthma control cohort and to that with moderate asthma annual cost per severe asthmatic patient resulted respectively about €892 and €606 higher, showing a corticosteroids shadow cost ranging from 45% to 30%. Applying the cost per patient to the target population identified for Italy, the budget impact model estimated a total annual cost related to OCS-related adverse events of €242.7 million for severe asthmatics. In respect with non-asthmatic and moderate population, an incremental expenditure of about € 110.6 million and €75.2, respectively, were shown. Conclusions: Our study provides the first estimates of additional healthcare costs related to corticosteroid induced adverse events in severe asthma patient. Budget impact model results highlighted the relevant economic impact of OCS-related adverse events in severe asthma patients. The future extrapolation of additional data from SANI registry will support the development of a model to investigate the role of corticosteroids sparing drugs.

Original languageEnglish
Article number100007
JournalWorld Allergy Organization Journal
Volume12
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Pharmaceutical Economics
Italy
Registries
Adrenal Cortex Hormones
Asthma
Costs and Cost Analysis
Health Services Needs and Demand
Budgets
Economics
Cost of Illness
Diagnosis-Related Groups
Health Expenditures
Health Care Costs
Population
Epidemiology

Keywords

  • Adverse events
  • Bone fracture
  • Chronic kidney disease
  • Costs
  • Diabetes
  • Glaucoma
  • Obesity
  • Oral corticosteroids
  • Pharmacoeconomy
  • Severe asthma

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

Shadow cost of oral corticosteroids-related adverse events : A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry. / SANI Network ; Canonica, Giorgio Walter; Colombo, Giorgio Lorenzo; Bruno, Giacomo Matteo; Di Matteo, Sergio; Martinotti, Chiara; Blasi, Francesco; Bucca, Caterina; Crimi, Nunzio; Paggiaro, Pierluigi; Pelaia, Girolamo; Passalaqua, Giovanni; Senna, Gianenrico; Heffler, Enrico.

In: World Allergy Organization Journal, Vol. 12, No. 1, 100007, 01.01.2019.

Research output: Contribution to journalArticle

SANI Network ; Canonica, Giorgio Walter ; Colombo, Giorgio Lorenzo ; Bruno, Giacomo Matteo ; Di Matteo, Sergio ; Martinotti, Chiara ; Blasi, Francesco ; Bucca, Caterina ; Crimi, Nunzio ; Paggiaro, Pierluigi ; Pelaia, Girolamo ; Passalaqua, Giovanni ; Senna, Gianenrico ; Heffler, Enrico. / Shadow cost of oral corticosteroids-related adverse events : A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry. In: World Allergy Organization Journal. 2019 ; Vol. 12, No. 1.
@article{3f434e10459545e085d770b323a630eb,
title = "Shadow cost of oral corticosteroids-related adverse events: A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry",
abstract = "Background: Asthma is one of the most common non-communicable respiratory diseases, affecting about 6{\%} of the general population. Severe asthma, even if afflicts a minority of asthmatics, drives the majority of costs of the disease. The aim of this study is to create a pharmacoeconomic model to predict the costs of corticosteroid-related adverse events in severe asthmatics and applying it to the first published epidemiologic data from the Severe Asthma Network in Italy (SANI) registry. Methods: The analysis was conducted from the perspective of the Italian National Healthcare System (INHS). Model inputs, derived from literature, included: asthma epidemiology data, frequency of adverse events, percentage of severe asthma treated with OCS and adverse event cost (Diagnosis-Related Group (DRG) national tariffs). We estimated costs per different patient groups: non-asthma controls, mild/moderate and severe asthmatics. Final results report estimated direct cost per patient and total direct cost for overall target population, showing economic impact related to corticosteroid complication. Results: Based on epidemiological data input, in Italy, asthmatic subjects resulted about 3,999,600, of which 199,980 with severe asthma. The number of patients with severe asthma OCS-treated was estimated at 123,988. Compared to the non-asthma control cohort and to that with moderate asthma annual cost per severe asthmatic patient resulted respectively about €892 and €606 higher, showing a corticosteroids shadow cost ranging from 45{\%} to 30{\%}. Applying the cost per patient to the target population identified for Italy, the budget impact model estimated a total annual cost related to OCS-related adverse events of €242.7 million for severe asthmatics. In respect with non-asthmatic and moderate population, an incremental expenditure of about € 110.6 million and €75.2, respectively, were shown. Conclusions: Our study provides the first estimates of additional healthcare costs related to corticosteroid induced adverse events in severe asthma patient. Budget impact model results highlighted the relevant economic impact of OCS-related adverse events in severe asthma patients. The future extrapolation of additional data from SANI registry will support the development of a model to investigate the role of corticosteroids sparing drugs.",
keywords = "Adverse events, Bone fracture, Chronic kidney disease, Costs, Diabetes, Glaucoma, Obesity, Oral corticosteroids, Pharmacoeconomy, Severe asthma",
author = "{SANI Network} and Canonica, {Giorgio Walter} and Colombo, {Giorgio Lorenzo} and Bruno, {Giacomo Matteo} and {Di Matteo}, Sergio and Chiara Martinotti and Francesco Blasi and Caterina Bucca and Nunzio Crimi and Pierluigi Paggiaro and Girolamo Pelaia and Giovanni Passalaqua and Gianenrico Senna and Enrico Heffler and Aliberti Stefano and Bagnasco Diego and Barbuto Sarah and Camiciottoli Gianna and Caminati Marco and Colombo Giselda and Teresa, {Costantino Maria} and Crimi Claudia and Crivellaro Mariangiola and Mariella, {D'Amato A.} and Favero Elisabetta and Pia, {Foschino Maria} and Guarnieri Gabriella and Latorre Manuela and Lombardi Carlo and Menzella Francesco and Patella Vincenzo and Puggioni Francesca and Ridolo Erminia and Rolla Giovanni and Savi Eleonora and Scichilone Nicola and Solidoro Paolo and Spadaro Giuseppe and Triggiani Massimo",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.waojou.2018.12.001",
language = "English",
volume = "12",
journal = "World Allergy Organization Journal",
issn = "1939-4551",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Shadow cost of oral corticosteroids-related adverse events

T2 - A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry

AU - SANI Network

AU - Canonica, Giorgio Walter

AU - Colombo, Giorgio Lorenzo

AU - Bruno, Giacomo Matteo

AU - Di Matteo, Sergio

AU - Martinotti, Chiara

AU - Blasi, Francesco

AU - Bucca, Caterina

AU - Crimi, Nunzio

AU - Paggiaro, Pierluigi

AU - Pelaia, Girolamo

AU - Passalaqua, Giovanni

AU - Senna, Gianenrico

AU - Heffler, Enrico

AU - Stefano, Aliberti

AU - Diego, Bagnasco

AU - Sarah, Barbuto

AU - Gianna, Camiciottoli

AU - Marco, Caminati

AU - Giselda, Colombo

AU - Teresa, Costantino Maria

AU - Claudia, Crimi

AU - Mariangiola, Crivellaro

AU - Mariella, D'Amato A.

AU - Elisabetta, Favero

AU - Pia, Foschino Maria

AU - Gabriella, Guarnieri

AU - Manuela, Latorre

AU - Carlo, Lombardi

AU - Francesco, Menzella

AU - Vincenzo, Patella

AU - Francesca, Puggioni

AU - Erminia, Ridolo

AU - Giovanni, Rolla

AU - Eleonora, Savi

AU - Nicola, Scichilone

AU - Paolo, Solidoro

AU - Giuseppe, Spadaro

AU - Massimo, Triggiani

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Asthma is one of the most common non-communicable respiratory diseases, affecting about 6% of the general population. Severe asthma, even if afflicts a minority of asthmatics, drives the majority of costs of the disease. The aim of this study is to create a pharmacoeconomic model to predict the costs of corticosteroid-related adverse events in severe asthmatics and applying it to the first published epidemiologic data from the Severe Asthma Network in Italy (SANI) registry. Methods: The analysis was conducted from the perspective of the Italian National Healthcare System (INHS). Model inputs, derived from literature, included: asthma epidemiology data, frequency of adverse events, percentage of severe asthma treated with OCS and adverse event cost (Diagnosis-Related Group (DRG) national tariffs). We estimated costs per different patient groups: non-asthma controls, mild/moderate and severe asthmatics. Final results report estimated direct cost per patient and total direct cost for overall target population, showing economic impact related to corticosteroid complication. Results: Based on epidemiological data input, in Italy, asthmatic subjects resulted about 3,999,600, of which 199,980 with severe asthma. The number of patients with severe asthma OCS-treated was estimated at 123,988. Compared to the non-asthma control cohort and to that with moderate asthma annual cost per severe asthmatic patient resulted respectively about €892 and €606 higher, showing a corticosteroids shadow cost ranging from 45% to 30%. Applying the cost per patient to the target population identified for Italy, the budget impact model estimated a total annual cost related to OCS-related adverse events of €242.7 million for severe asthmatics. In respect with non-asthmatic and moderate population, an incremental expenditure of about € 110.6 million and €75.2, respectively, were shown. Conclusions: Our study provides the first estimates of additional healthcare costs related to corticosteroid induced adverse events in severe asthma patient. Budget impact model results highlighted the relevant economic impact of OCS-related adverse events in severe asthma patients. The future extrapolation of additional data from SANI registry will support the development of a model to investigate the role of corticosteroids sparing drugs.

AB - Background: Asthma is one of the most common non-communicable respiratory diseases, affecting about 6% of the general population. Severe asthma, even if afflicts a minority of asthmatics, drives the majority of costs of the disease. The aim of this study is to create a pharmacoeconomic model to predict the costs of corticosteroid-related adverse events in severe asthmatics and applying it to the first published epidemiologic data from the Severe Asthma Network in Italy (SANI) registry. Methods: The analysis was conducted from the perspective of the Italian National Healthcare System (INHS). Model inputs, derived from literature, included: asthma epidemiology data, frequency of adverse events, percentage of severe asthma treated with OCS and adverse event cost (Diagnosis-Related Group (DRG) national tariffs). We estimated costs per different patient groups: non-asthma controls, mild/moderate and severe asthmatics. Final results report estimated direct cost per patient and total direct cost for overall target population, showing economic impact related to corticosteroid complication. Results: Based on epidemiological data input, in Italy, asthmatic subjects resulted about 3,999,600, of which 199,980 with severe asthma. The number of patients with severe asthma OCS-treated was estimated at 123,988. Compared to the non-asthma control cohort and to that with moderate asthma annual cost per severe asthmatic patient resulted respectively about €892 and €606 higher, showing a corticosteroids shadow cost ranging from 45% to 30%. Applying the cost per patient to the target population identified for Italy, the budget impact model estimated a total annual cost related to OCS-related adverse events of €242.7 million for severe asthmatics. In respect with non-asthmatic and moderate population, an incremental expenditure of about € 110.6 million and €75.2, respectively, were shown. Conclusions: Our study provides the first estimates of additional healthcare costs related to corticosteroid induced adverse events in severe asthma patient. Budget impact model results highlighted the relevant economic impact of OCS-related adverse events in severe asthma patients. The future extrapolation of additional data from SANI registry will support the development of a model to investigate the role of corticosteroids sparing drugs.

KW - Adverse events

KW - Bone fracture

KW - Chronic kidney disease

KW - Costs

KW - Diabetes

KW - Glaucoma

KW - Obesity

KW - Oral corticosteroids

KW - Pharmacoeconomy

KW - Severe asthma

UR - http://www.scopus.com/inward/record.url?scp=85064080220&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064080220&partnerID=8YFLogxK

U2 - 10.1016/j.waojou.2018.12.001

DO - 10.1016/j.waojou.2018.12.001

M3 - Article

AN - SCOPUS:85064080220

VL - 12

JO - World Allergy Organization Journal

JF - World Allergy Organization Journal

SN - 1939-4551

IS - 1

M1 - 100007

ER -