Although asthma is recognised as a common condition in Australia, the exact number of persons suffering from asthma is unknown (Abramson, 1989). This is partly a function of different prevalence estimates produced by slightly different study methods, but more importantly the result of difficulties in diagnosing the disease. It is widely acknowledged, however, that between 8% and 9% of Australians - around 1.4 million people - are clinically diagnosed asthmatics (ABS 1989/90 National Health Survey). The high prevalence of asthma and its potential impact on the community highlights the need for a good understanding of the economics of the disease. Until recently, however, the total cost of asthma to the Australian community has been poorly researched and understood.

There are significant medical and indirect costs associated with asthma. Medical costs arise from the considerable demand asthmatics place on health services in the form of: general practitioner (GP) time, medication, specialist time, emergency attendances, and hospital outpatient and inpatient services. Indirect costs arise from reduced productivity caused by asthma. These include the cost to employers of working days lost, reduced effectiveness whilst at work, and travelling time to appointments. Figure One summarises all the potential cost elements of asthma and their definitions.

The list includes costs that can accurately be quantified and those measures, such as quality of life, that are difficult to value in monetary terms. Any total monetary cost of asthma must be viewed with these considerations in mind as the unquantifiable costs of reduced quality of life for sufferers and their families and the asthmatic's resultant diminished capability to contribute to society are likely to be significant.

The impact of asthma is not uniform across all asthmatics but varies with disease severity and effectiveness of control provided by treatment. The majority of asthmatics suffer from very mild or mild disease with only intermittent or exercise induced symptoms. Moderate asthmatics generally experience daily symptoms and have lifestyles which are significantly affected by their illness. Severe asthma is a disabling illness which results in significant daily symptoms, sleep disturbance and the need for hospitalisation in the case of serious exacerbation. The costs of asthma, both in quality of life and financial terms, therefore increase as the severity of the disease increases.

Effective treatment and control of asthma affect not only an asthmatic's lifestyle but the disease's economic and social cost. Australian asthma specialists' opinion and a recent survey undertaken by the National Asthma Campaign provide evidence that a significant proportion of diagnosed asthmatics are currently receiving treatment which does not provide the best possible control of the disease. This poor control generates additional costs to both the individual and society. Costs arise from the individual with poorly controlled asthma having a greater need for medical care and rescue medication as well as potentially avoidable hospital emergency presentations and admissions.

Content Updated 1992