Title: Identifying the true cost of asthma in the UK: secondary analyses of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales
Funder: Asthma UK

Abstract: Background Asthma can occur at an early age and often continues throughout life. The rate of asthma in children is particularly high in the UK. This poses a significant health burden on the individual with asthma over a lifetime and on family members and also a financial burden on healthcare services and the wider economy. We need to understand the extent of these burdens so that we can focus resources on where they are most needed to improve asthma care. We also need to find where there are gaps in information to allow us to better address the important issues in asthma care and where future research needs to be done. There are large gaps in our knowledge of the costs of asthma to individuals/families and society. Previous reports on lung disease have not reported specific costs relating to, for example, absences of children from school, work absences, loss of productivity and premature retirement, benefit entitlement associated with asthma. The information we currently have on asthma rates in the UK is out of date. We need more up-to-date information and need to know whether the burden of asthma continues to rise. We also need an accurate assessment of asthma costs to the economy and society as a whole. This will give us a powerful tool to highlight the need for resources and an important starting point in identifying where those resources are most needed to improve the care of people with asthma. Aims of this study We plan to provide: Up-to-date information on the number of people with asthma across the UK Accurate and comprehensive assessment of the healthcare costs of asthma and also the costs to society and the UK economy Insights into how the relative costs and effectiveness of different treatment approaches could be assessed and compared and how this might allow us to estimate what changes in asthma care would lead to a more cost-effective service Methods We have already identified a number of high quality sources of information routinely available in England, Northern Ireland, Scotland and Wales, which will allow us to estimate what percentage of the UK population (and each of its member countries) suffers from asthma, to understand patterns of use of the NHS and to obtain insights into the wider impact of asthma on individuals, families and society as a whole. Through statistical analysis of these data, we aim, amongst other things, to provide information on the following costs: Direct costs to the NHS: these will include the number of asthma related GP and nurse consultations, out of hours consultations (e.g. NHS24/NHS Direct), medicines taken, physiotherapy, outpatient appointments hospital and intensive care unit (ICU) admissions. We will look at the breakdown of costs across the NHS e.g. costs of clinical time, medications etc. Wider public sector and societal costs: these will include lost school and work days, disabilities, premature retirement and death resulting from asthma and will be used to investigate the financial implications of asthma on wider society. The team This application brings together leading asthma researchers from across the UK who have conducted similar work in relation to asthma in the past and are very well-placed to undertake this study. Members of our research team have expertise across a range of relevant clinical and research fields including general practice/nursing, paediatric and adult specialist asthma care, public health, social care, epidemiology, statistics, data linkage and analysis, geography and health economics. Importantly, we have access to the relevant databases and considerable experience of working with these. We have recently developed new ways of securely and confidentially linking data, which we will use to bridge the gaps in current knowledge regarding asthma costs. Given the strategic importance of this work, we will invest significant to support the undertaking of this work to international standards (see letter of support from McKinstry). The


Research activity codes: 2.4 SURVEILLANCE AND DISTRIBUTION;8.2 HEALTH AND WELFARE ECONOMICS
Health categories: RESPIRATORY