Corticosteroids Could Increase Costs, Healthcare Utilization in Patients with Severe Asthma

Healthcare utilization and costs increased with higher doses of corticosteroids.

Researchers in a new study discovered a dose-response relationship between corticosteroids and related complications in patients with severe asthma.

Systemic corticosteroids (SCS) are the recommended treatment for patients with severe asthma when other treatments have failed.

Long-term use of SCS can cause complications such as fractures, susceptibility to infections, obesity, stroke, cataract, and skin thinning, according to a study published by the Journal of Managed Care & Specialty Pharmacy. Researchers examined the Commercial Claims and Encounters database and the Medicare Supplemental Coordination of Benefits database to distinguish whether or not there was a difference in complications related to doses.

Claims from 12,697 SCS users and 590,450 non-SCS users were included.

The researchers calculated healthcare resource utilization and costs relating to SCS complications through medical claims with a diagnosis, or pharmacy claims for medications to treat the complications, according to the study.

Researchers found that SCS users were more likely to develop complications compared with nonusers. Increased exposure to SCS increased the likelihood of complications, as well.

Healthcare resource utilization due to complications was significantly increased in patients with higher degrees of exposure compared with patients with lower degrees or no exposure. Patients with low exposure had a SCS-related healthcare cost of $2670, and patients with high exposure had a cost of $9162.

Researchers hypothesized that the increase in healthcare resource utilization and costs could be related to follow-up visits or treatments for complications.

“We found that among a large US commercially insured population, patients with severe asthma who had been treated for at least 6 months with a daily dose of at least 5 mg of prednisone had a significantly higher risk of developing SCS-related complications compared with those not exposed to SCSs and that this risk significantly increased with SCS exposure,” the study concluded. “We also found a significant incremental burden on healthcare resources and costs associated with SCS-related complications for SCS users compared with SCS nonusers and that this effect was significant even at daily doses < 5 mg prednisone equivalent.”