Out-of-Pocket Cost Deter Asthma Treatment

Asthma treatment expenses led to decrease in usage for children

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) The out-of-pocket cost of a child's asthma puts a strain on a family's wallet and on the child's health. The cost of asthma treatment has led to reduced medicine use and more hospitalizations.

For some families who are privately insured, the shared cost of asthma medication for their child may be too much.

The increased cost of asthma medication was associated with a minor reduction in treatment usage and increased asthma-related hospitalization in children aged five and older.

"Ask your doctor about local asthma programs."

The study was led by Pinar Karaca-Mandic, Ph.D., from the University of Minnesota. Researchers analyzed medical data from insurance plans of 8,834 asthmatic children between 1997 and 2007. While asthma medication usage was low for all participants, when the cost of asthma medication was increased the adjusted medication usage decreased while the number of hospitalizations increased.

Out of the 8,834 children, 2,921 were aged five and younger while 5,913 were aged between five and 18. The average age of all children in the study was 9.7 years of age. For families, the average out-of-pocket cost for a child's asthma medication was $154 for children aged five to 18 and $151 for children younger than five years old.

According to Aetna, an insurance company, the estimated cost for asthma treatment is $150 dollars a month. This number will be different for many people based on doctor visits, type of plan and medication needs.

For families with private insurance, children, between the ages of five and 18, with asthma were only covered for 40.8 percent of the year, based on the number of prescriptions filled. Children under the age of five were covered for 46.2 percent of the year.

Children younger than five were more likely to go to the emergency room than children between the ages of five and 18. For the year, 7.9 percent of children under the age of five had to go to the emergency room while 3.7 percent of children between the ages of five and 18 had to go to the emergency room due to asthma.

When the out-of-pocket cost increased from the lowest quarter to the second-highest quarter, asthma medication usage decreased in children aged between five and 18 but there was no change in treatment usage for children under the age of five. For children whose families had to pay the highest out-of-pocket cost, hospitalizations were higher in children between the ages of five and 18 than other children who had to pay less.

There was no difference in children under the age of five.

Just because someone may have insurance does not mean every disease is treated. Out-of-pocket costs are a concern for the family but just as important is the low rate of medication usage. Children who are only covered for 40 percent of the year do not get treatment for their symptoms for the majority of the year. Better education in regards to the importance of asthma medication usage could increase the number of days children with asthma are covered for. 

This study was funded by National Institute of Child Health and Human Development, the National Institute on Aging, and the Royal Center for Health Policy Simulation.

This study was published in the March edition of JAMA.

Reviewed by: 
Review Date: 
March 30, 2012
Last Updated:
April 1, 2012