October 27, 2005

Asthma-reducing program worth cost: study

By Charnicia Huggins

NEW YORK (Reuters Health) - Home-based efforts to reduce
the amount of allergy triggers in the homes of children with
asthma not only work well but also appear to be worthwhile in
terms of costs and savings, new findings show.

"Our previous study demonstrated that an intervention
designed to reduce the exposure of asthmatic inner-city
children to environmental irritants and allergens at home
succeeded in reducing asthma symptoms," study author Dr. Meyer
Kattan told Reuters Health.

"The current study shows that a reduction in morbidity can
be achieved with this home-based environmental intervention in
a cost-effective manner," added Kattan, of Mount Sinai School
of Medicine in New York City.

Asthma is known to be particularly common among children
living in the inner city, and is thought to be partially due to
various environmental factors such as exposure to cockroach
antigen and other indoor allergy-producing substances and

Findings from the previously published Inner-City Asthma
Study showed that a home-based intervention was successful in
reducing the levels of such irritants and allergens.

That intervention used trained environmental counselors to
teach families to use pillow covers that are impermeable to
dust mites, air purifiers to get rid of tobacco smoke or mold,
and other ways to reduce exposure to various asthma triggers.
The study participants were more than 900 children, aged 6 to
11, with moderate-to-severe asthma from seven urban locations,

The current study was conducted to evaluate the
cost-effectiveness of the initiative.

The intervention cost $1,469 per family, but it reduced the
study participants' annual number of unscheduled visits to the
clinic by 19 percent and reduced the number of asthma inhalers
used each year by 13 percent, Kattan and colleagues report.

This reduction in the use of asthma services was
"sufficient to offset approximately one third of the
intervention costs," they write in the Journal of Allergy and
Clinical Immunology.

During the two-year study period, including one year of
follow-up, children in the study group had nearly 40 more
symptom-free days -- at a cost of about $28 per day -- than did
children in a comparison group.

Whether the intervention is cost-effective, i.e. worth its
cost to the payer, depends on how much the payer values
symptom-free days, the report suggests.

According to Kattan, the current findings "support current
international asthma guidelines stating that attention to
exposures in the home environment is an integral part of asthma

In light of the findings, Kattan recommends that
"environmental interventions should be considered as an
important part of public health programs for asthma management
of children in inner-cities."

"This economic analysis can be useful for prioritizing
decisions regarding asthma care in this underserved
population," the researcher added.

SOURCE: Journal of Allergy and Clinical Immunology, online
October 11, 2005.