Cost-effectiveness of asthma clinic approach in the management of chronic asthma in Australia

Mogasale, Vittal and Vos, Theo (2013) Cost-effectiveness of asthma clinic approach in the management of chronic asthma in Australia. Australian and New Zealand Journal of Public Health, 37 3: 205-210. doi:10.1111/1753-6405.12060

Author Mogasale, Vittal
Vos, Theo
Title Cost-effectiveness of asthma clinic approach in the management of chronic asthma in Australia
Journal name Australian and New Zealand Journal of Public Health   Check publisher's open access policy
ISSN 1326-0200
Publication date 2013-06
Sub-type Article (original research)
DOI 10.1111/1753-6405.12060
Open Access Status
Volume 37
Issue 3
Start page 205
End page 210
Total pages 6
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell
Collection year 2014
Language eng
Formatted abstract
Objectives: To compare cost-effectiveness of an asthma clinic that would provide education, promotion of self-monitoring of symptoms, regular review of treatment by a medical practitioner and a written asthma action plan to current practice in Australia.

Methods: A decision tree model was used to compare treatment and improved management using asthma clinics under three scenarios: 1) intervention reduces only emergency department visits; 2) in addition, it leads to a reduction in days out of role; and 3) it also reduces unplanned general practitioner visits and hospitalisations. Evidence from existing published studies was used for asthma incidence, duration, treatment practices and health seeking behaviours. Costs for one year were estimated based on an asthma clinic trial in Australia.

Results: The estimated $274 million annual cost of asthma clinics is much greater than the potential cost savings of $11 million resulting from reduced emergency department visits, and an overall potential cost saving of $85 million resulting from decreased GP visits and hospitalisations. The incremental costeffective ratio (ICER) is $24,000 if a reduction in days out of role is quantified as a health benefit in estimating disability adjusted life years (DALY). If a potential $85 million in cost-savings from decreased emergency department visits, GP visits and hospitalisation is taken into account, the ICER drops to $17,000 per DALY averted.

Conclusions: An asthma clinic as an intervention for improving self-management may be cost-effective in Australia if multiple benefits can be achieved. Implications: A large-scale asthma clinic trial and long-term evaluation of benefits are necessary to obtain stronger evidence on the benefit of asthma clinic approach in Australia.
Keyword Asthma clinic
Optimal self-management
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
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