C38-02 Evaluating Cost and Activity Impairment in Adult Patients With Asthma in a Sub-Saharan Country

Abstract Rationale Asthma is a common, complex, cross-country and chronic disease with substantial economic and humanistic impact. Most of the mortality from asthma occurs in low-middle income countries, which are also experiencing rising inflation rates. There is sparse literature on the cost and activity impairment of asthma in Nigeria; the main goal of this study is to evaluate the economic cost of adults with asthma in a Nigerian tertiary hospital and its association with asthma control. Methods We consecutively recruited physician-diagnosed adult patients with asthma cross-sectionally in the respiratory clinic of Obafemi Awolowo University Teaching Hospitals Complex. We used a bottom-up approach to estimate the cost of illness in asthma. Total direct medical costs were calculated as the sum of hospitalizations, outpatient visits (scheduled and unscheduled), transportation, investigations and medication costs. Indirect cost was estimated using numbers of hours spent outside work for each visit, while asthma control was evaluated with Asthma Control Test scores, categorizing patients as uncontrolled (scores ≤ 19 and controlled (scores 20–25). Activity impairment was evaluated with the Work Productivity and Activity Impairment Questionnaire. Generalized linear models, controlling for covariates of age and BMI was used to examine whether outcomes differed by asthma control. Results A total of 66 patients was analyzed, (mean age 40 (SD 15), 72% female); 33 of the patients had uncontrolled asthma (50%). The average annual direct and indirect costs of the treatment were N387,276 ($2091.21) and N12,816 ($69.2), respectively, per patient (values in US dollars are based on purchasing power parity (PPP) of 2025. Compared to patients with uncontrolled asthma, patients with controlled asthma have a lower total direct cost of asthma (N357,959 vs N420,908; p = 0.150), additionally, the indirect cost of patients with controlled asthma is significantly lower (N 8,933 vs N17,163; p = 0.005). Activity impairment for all the participants is significantly lower in those with controlled asthma compared with uncontrolled asthma (3% vs 30%; p = 0.001) Conclusion The cost of asthma is substantially high in Nigeria, and patients having uncontrolled asthma significantly contribute to this cost. Measures to reduce the cost of illness in asthma may improve asthma control and reduce activity impairment. This abstract is funded by: None