Abstract
Background: Quantifying age trends in healthcare costs of pediatric
asthma leads to better understanding of the natural history of the
disease and informed decision-making on the allocation of healthcare
resources. Methods: We identified children with incident asthma from the
health administrative data of British Columbia, Canada (Jan 1998 to Dec
2015), and followed them from their first diagnosis of asthma or
wheezing until age 18. We estimated direct medical costs (in 2016
Canadian dollars [$]), including inpatient and outpatient
encounters and pharmacy costs, attributed to asthma (primary outcome)
and other respiratory diseases (secondary outcome). We assessed the
impact of sex and socioeconomic status on age trends, adjusting for
calendar effect. Results: The final analysis included 44,552 children
with asthma (62% boys). From age 0 to 18, costs of asthma/wheezing and
other respiratory conditions decreased from $1,036 to $29/child-year,
and from $1,145 to $31/child-year, respectively. Children under 3
years of age incurred 4–fold higher costs for asthma/wheezing and other
respiratory conditions. In particular, costs of asthma hospitalizations
were 10 times higher in this age group compared to older children. Age
trends were generally similar between sex groups and across
socioeconomic status. However, medication costs for asthma/wheezing
decreased in boys, whereas those in girls declined during childhood but
increased during adolescence. Conclusions: The highest costs of
pediatric asthma are concentrated in children younger than 3. Age trends
were generally consistent between sex and across socioeconomic status.