Direct and indirect costs of asthma to an employer

Background: Asthma is a chronic inflammatory condition of the airways that has a significant effect on the use of health care resources. Objective: This study is the first of its kind to estimate the overall cost of asthma to a major employer in the United States and to profile the nature of the asthma expenses. Methods: The annual per capita cost of asthma was determined for beneficiaries of a major employer by analyzing medical, pharmaceutical, and disability claims data. The incremental cost of asthma was determined by using a case-control method matching asthmatic patients to individuals with no record of asthma treatment. Results: The use of health care services, as well as the rate of disability, was substantially higher among asthmatic patients than among control subjects. Annual per capita employer expenditures for asthmatic patients were approximately 2.5 times those for control subjects ($5385 vs $2121, respectively). Among asthmatic employees with disability claims, total costs were approximately 3 times higher than those among disability claimants in the employee control sample ($14,827 vs $5280). For asthmatic employees, wage-replacement costs for workdays lost as a result of disability and sporadic absenteeism (40%) accounted for almost as much as did medical care (43%). Conclusion: Failure to account fully for the broader consequences of asthma in terms of indirect and comorbid treatment costs would result in a significant underassessment of the cost of asthma to an employer.