Epidemiological, clinical and economic burden of severe eosinophilic asthma in Taiwan: Results from a large tertiary care hospital
Sumitra Shantakumar,1 Yu-Fan Ho,1 Li-Wen Tuan,2 Tzu-Mei Lin,3 Yi-Hsing Chen3
Affiliations:
1 Department of Epidemiology, GlaxoSmithKline, GSK Asia House, Singapore
2 Formosa Biomedical Technology Corp. CRO Division, Taipei, Taiwan
3 Taichung Veterans General Hospital, Taichung, Taiwan
Abstract
Background: Burden of severe eosinophilic asthma (SEA) data in Asia are limited.
Objective: This retrospective, observational study characterized SEA epidemiology, healthcare resource use (HCRU) and costs for adult patients in Taiwan.
Methods: Data from Taichung Veterans General Hospital electronic medical record database, between 2013 to 2016, were extracted. Eligible general asthma patients were ≥ 18 years at index date, with ≥ 1 medical claim with an asthma diagnosis after the index date. Patients with SEA (meeting additional criteria: Global Initiative for Asthma Step 4/5 treatment guidelines [within 3 months preceding index date], ≥ 2 clinically significant exacerbations, and eosinophil counts ≥ 300 cells/μL [within 12 months preceding index date] or ≥ 150 cells/μL [on index date]) and SEA patients using high-dose inhaled corticosteroids (HD ICS) were also identified. Twelve months’ pre-index data were used to evaluate exacerbation frequency, treatment patterns, HCRU, and costs (2016 US Dollars).
Results: Of 2,601 eligible general asthmatic patients, 162 (6.2%) met predefined criteria for SEA; of SEA patients, 72/162 (44.4%) had used HD ICS. SEA and HD ICS SEA patients experienced more clinically significant exacerbations than general asthma patients (1.6 ± 3.3 and 1.5 ± 2.6 vs 0.6 ± 2.0, p < 0.01). HD ICS SEA and SEA patients incurred at least 2–2.5-fold higher total asthma-related and all-cause costs than general asthma patients and had significantly greater HCRU.
Conclusions: Of eligible Taiwanese general asthma patients, 6.2% met predefined SEA criteria. Compared with general asthma patients, SEA and HD ICS SEA patients used more respiratory medications, experienced more exacerbations, and incurred greater HCRU and higher costs.
Key words: severe eosinophilic asthma, high-dose inhaled corticosteroids, Taiwan, epidemiology, health care costs