A study by SingHealth Polyclinics (SHP) and Duke-NUS found that asthma patients who are overweight and smoke incur higher treatment costs. The study also found that patients who use the more costly combination drug may pay more initially, but incur lower treatment cost in the long run.

 

The 10-year study examined the data of 939 SHP patients under the Singapore National Asthma Programme (SNAP). It was published in the European Respiratory Journal in December.

 

The data revealed that every year, an overweight patient pays S$70 more in asthma costs than their normal weight counterpart, who pay S$605. An obese patient pays almost S$200 higher. The researchers also found that patients who smoke had higher annual treatment expenses than non-smokers. The study used pre-subsidy charges to compute the data.

 

Dr Tan Ngiap Chuan, director of research at SHP, said that the findings may help doctors plan a more holistic treatment for asthma patients and reduce their cost burden. Asthma affects as many as 10 per cent of the Singapore’s population, with about 5 per cent of adults and 20 per cent of children having asthma.

 

The study also found that patients can better control their asthma if they shift from controller drugs to a combination drug. Assistant Professor Nguyen Van Hai, from Duke-NUS Health Services & Systems Research Program, said,  “Although this means that the patient pays more up front for the combination drug, it pays off in the long run because their condition is better controlled and they need fewer visits to the doctor. We also factored in indirect costs such as loss of work days”

 

“Over a decade ago, we found that patients kept returning for acute management of asthma attacks even though medication was available to control their condition,” said Dr Tan. “Asthma control is within the patient’s power, but they must know exactly what to do. All this takes time, effort, resources and counselling by healthcare professionals.”

 

Under SNAP, the study involved healthcare professionals gathering the data from asthma patients at the Pasir Ris and Outram polyclinics. Nurses were also trained to educate patients on their asthma management, book follow-up visits and call the patients should they fail to return for reassessment to ensure continuity of care.

 

After nine years of collecting data, SHP teamed up with Duke-NUS statisticians with experience in the healthcare economics, to analyse the data.

 

Dr Tan said, “Ultimately, we want equity in the way we care for patients, we don’t want cost to be a barrier to good and effective treatment.”