Limited data are available about costs of asthma care by general practitioners (GPs) in
France. This study evaluated asthma care costs of children treated by GPs, and the relationship
between cost and asthma control across different degrees of asthma severity.
We conducted a retrospective longitudinal observational study based on a computerized
prescription database of GPs supplemented with a cross-sectional survey of children aged
6–16 with persistent asthma (GINA step ≥2). Retrospective data on asthma-related medical
resource utilization (MRU) were collected for a 12-month study period. MRU included antiasthma
medications, visits to GPs, visits to emergency rooms, and hospitalizations. Asthma
control was evaluated from recent asthma symptoms, whereas severity was defined by the
average dose of inhaled corticosteroids prescribed during a preindex period. Univariate and
multivariate analyses were used to evaluate relationships between MRU and other variables
of interest. Among 261 children with completed surveys, the proportion of total MRU cost
due to GP visits, medications, and emergency room visits was 20%, 30%, and 2%, respectively.
Although hospitalizations accounted for almost 50% of total costs, only 17 children
(6.5%) were hospitalized during the study period. In children with severe asthma, total MRU
cost was significantly higher when control of asthma was poor, compared with moderate
and good levels of asthma control (p = 0.004). However, no similar association emerged in
children with low and moderate severity. A minority of children with high-cost medical use
accounted for a significant part of total expenditures. Total MRU costs varied according to
level of control in children with high disease severity. (Pediatr Asthma Allergy Immunol
2005; 18[1]:36–45.)
