Incremental Medical Costs Of Asthma Among US Workers

Background: Asthma is a chronic respiratory disease that affects a number of individuals, including workers. Asthma treatments have advanced in the recent past but the cost of these treatments continue to represent a large economic burden for the nation, in terms of both medical costs and productivity losses and reduced health-related quality of life. Assessing the current economic burden of asthma on workers will provide important information on the impact of this disease on the nation, and guide decisions about the allocation of limited resources to reduce the incidence and prevalence of asthma among workers.

Objectives: This study uses national level data on the prevalence of asthma and estimates the incremental medical costs associated with asthma. In addition, it estimates the association of incremental medical cost of asthma with several other factors, including race/ethnicity, age, gender, education, family income, and insurance status.

Data and Methodology: Data used in this study is obtained from the household component of the Medical Expenditure Panel Survey for the years 2014 and 2015. The study cohort had at least one medical claim or pharmaceutical encounter associated with asthma. Medical claims associated with asthma are identified by ICD 9 codes and clinical classification codes. Descriptive and two-part model analyses are used in this study. The two-part regression model estimates the annual per-person incremental medical cost. In the first part, the probability of a worker having a medical claim or pharmaceutical encounter associated with asthma is estimated utilizing logistic regression model. In the second part, a general linear model with gamma distribution and log link is utilized only for those workers who had a medical claim or pharmaceutical encounter with a positive cost. The first part of the model therefore uses the complete dataset whereas the second part uses data only on the worker population that had a positive cost associated with asthma. All costs are adjusted for inflation and are expressed in 2015 dollar values.

Results: There are 313 million workers in the pooled data, out of which a little more than 16 million workers (5.2 percent) have at least one medical claim associated with asthma. Descriptive statistics for the worker population demonstrate that the average medical cost of asthma is $3600, compared with $4056 for the whole population. Preliminary results show that the incremental medical cost of asthma per worker is $3,579 (in 2015 US dollars).

Conclusion: Asthma places a large economic burden on the United States. Previous studies have shown that it was $81.9 billion in 2013 (Nurmagambetov, 2018), including costs incurred by absenteeism and mortality. This study focuses only on workers and according to the preliminary results, the total medical cost of treating their asthma in 2014 and 2015 was approximately $58 billion.