The 130th Annual Meeting of APHA

Abstract #50060

David Mudarri¹, Kathleen Cunningham, PhD², Ben Apelberg², and Mark Heil, PhD¹. (1) Indoor Environments Division, U.S. Environmental Protection Agency, 501 3rd St. N.W., Washington, DC 20005, (2) Environmental Research Area, Abt Associates, 55 Wheeler St., Cambridge, MA 02138, (617) 349-2776, mudarri.david@epa.gov

Asthma is a serious, chronic, and potentially life-threatening illness, and the national medical costs for treating persons with asthma is significant. A substantial portion of these costs are borne by managed care organizations (MCOs) and other health insurers who thus have an incentive to adopt asthma management programs to reduce those costs. This paper estimates the potential savings in medical costs that MCOs could experience by administering asthma management programs (AMPs) including programs to help individuals control their exposure to environmental asthma triggers. To estimate the potential savings associated with trigger avoidance strategies, data on the dose response relationship of individual triggers was combined with estimates and assumptions related to the proportion of asthmatics sensitive to the trigger, the proportion of those sensitive that are exposed, the degree of compliance by both the patient and the doctor to an MCO=s trigger avoidance program, and the potential effectiveness of the trigger avoidance program. The structure of the analysis is designed to aid individual MCOs in estimating their own potential cost savings, while at the same time provide some estimates based on available literature. Environmental triggers studied were environmental tobacco smoke, dust mites, pet dander, cockroaches, and mold. Health care services for which cost estimates were derived included doctor visits, emergency room visits, hospitalizations, and medication. Estimates focused on moderate to severe asthmatics since most of the cost of treatment is associated with these individuals.

Learning Objectives: At the conclusion of this presentation the participant will

• understand the effectiveness of asthma management plans (AMPs)in reducing morbidity.
• understand the commonly encountered asthma triggers in indoor environments and the level of risk reduction that can be achieved by reducing exposure.
• understand the medical service cost savings that can be achieved through AMPs with trigger avoidance components.
• be able to provide a cost-effectiveness argument for implementing effective AMPs that include asthma trigger avoidance strategies.

Keywords: Asthma, Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.