To
contact RAMP, please DO NOT respond to this email…by doing so you will email
everyone in the group. Please email us
directly at info@rampasthma.org.
Dear RAMP Partners,
You have been added to a growing email
list to receive asthma related updates for the California Bay Area, including
funding announcements, legislative action alerts, information about events
and changes to the RAMP website. To remove yourself from this list at any
time or to add someone, please email RAMP at info@rampasthma.org.
You can also get updates on our website
at http://www.rampasthma.org. The first page of the site contains
a pop-up window that will guide you to newly added/revised sections of the
site. While there, you can access many pages of information, including the
California Bay Area Asthma Calendar to learn about upcoming events, and add
your own, post on the asthma message board, and sign-in to give information
about your asthma program. I hope you find the website and this list helpful.
Please contact me if you have any comments.
UPDATES:
Below is a recent press release regarding
a national study regarding the rising economic costs associated with asthma.
This study, published in the September 2000 issue of the Journal of Allergy and Clinical Immunology, can also be accessed and
searched by county on the Allergy and Asthma Foundation of America’s website
at http://www.aafa/highcosts.
Also, you may have recently received
information and an application for the upcoming CHEST conference in San Francisco
from October 22-26. Thank you to the
work of the Yes We Can Urban Asthma
Partnership in San Francisco some RAMP partners will receive scholarships
for the event. If you were sent a
packet from CHEST, check your registration form for “Fee Waived” to see if
you received one.
Thank you,
Megan Webb, RAMP
Director
http://www.rampasthma.org
Surgeon General Calls for
Recommendations to Bring Down Costs, Improve Treatment
Washington, D.C. (September 13, 2000)
- A newly released national study shows that costs associated with asthma
shot up 54 percent over a ten-year period, clearly indicating that an alarmingly
high number of the 15 million Americans with asthma still frequently seek
crisis care.
"We feel this study clearly indicates
that many people are not getting the advanced care they need to control their
asthma," said Kevin Weiss, M.D., the lead author of the study. "The
study found a high percentage of indirect costs due to lost wages and productivity
because of persistent asthma, reflecting the toll taken on the individual
with asthma and the economic well being of society."
The study, published in the
September 2000 issue of the Journal of
Allergy and Clinical Immunology, prompted U.S. Surgeon General David
Satcher to call on leading asthma advocacy and research groups to identify
remedies to asthma's growing economic burden and to promote better treatment of
the chronic disease.
"We need to identify more effective
interventions that improve asthma care in this country and apply those that
we know work," Dr. Satcher said at a media briefing today at the Mayflower
Hotel in Washington, D.C. "Fortunately, there is a great deal of cumulative
wisdom within the asthma care community about what works. Our challenge is
to ensure that both providers and patients are aware of and heed these best
practices."
The Asthma and Allergy Foundation of
America, which sponsored the study, accepted Dr. Satcher's call to action
and agreed to convene a task force of health care associations and professional
societies to analyze the dramatic rise in asthma care costs between 1985,
the baseline year of the study, and 1994. Next year, the task force will issue
recommendations about reducing costs and sharpening the effectiveness of asthma
care.
"This research clearly indicates
that many people are not getting the advanced care and education they need
to control their asthma," said Dr. Steve Sesterhenn, President of AAFA's
Board of Directors. "AAFA is poised to convene the Asthma Leadership
Council, a task force that will review the trouble spots identified in the
study and offer recommendations about how our health care system might provide
better access and treatment. This council would also review the recognized
need for a nationwide health-tracking network to identify what is causing
this horrible disease.
Researchers estimated in the study,
"Trends in the Cost of Illness for Asthma in the United States,
1984-1994," that asthma drained the United States of an estimated $10.7
billion in 1994, up from an estimated $4.5 billion, or $7 billion when adjusted
to 1994 dollars.
Indirect costs of asthma in 1994: $4.64 billion. Indirect costs associated with asthma
- workdays lost, time lost from school and costs attributed to asthma deaths
- rose far more sharply in real dollars between 1985 and 1994 than did direct
medical expenses. Indirect costs went from nearly $2 billion in adjusted 1985
dollars to $4.64 billion in 1994, a 133 percent increase.
Costs associated with time adults lost
from work because of their own asthma quadrupled over the last 10 years, representing
the steepest rise in indirect costs. Lost work time costs for caregivers of
people with asthma- typically parents who stayed home when their children
were too sick to go to school-- increased 88 percent. Premature death of people
with asthma, which rose 41.4 percent between 1985 and 1994, caused costs associated
with asthma mortality to increase 151 percent.
Direct medical costs for asthma care in 1994: $6 billion. Direct medical expenditures (or
DME, which includes hospitalizations, doctors' visits and medications) were
nearly $5 billion in 1985 and just over $6 billion in 1994. By far, medication
expenditures were, in 1994, the largest component cost of DME at 40.1 percent -
up from 30 percent in 1985.
Indeed, between 1994 and 1985, the total number of prescriptions for asthma
rose by 103.2 percent and total expenditures for asthma medications increased
from $1.4 billion in 1985-adjusted dollars to about $2.5 billion in 1994.
"The increased costs related to
asthma medications is, in and of itself, not alarming," said Dr. Weiss.
"But with that rise in medication costs, we would have expected a large
decrease in hospitalizations. That's to say, if the appropriate medications
- namely, anti-inflammatories -- were being used according to national treatment
guidelines, fewer people would have found themselves in crisis and requiring
hospitalization."
While the length of hospital stays
decreased 23 percent, reflecting a trend for hospitals to discharge people
with asthma sooner, in-patient asthma care went down only negligibly - from
467,000 total hospital discharges between 1983 to 1985 to 460,000 between
1993 to 1995. The total number of emergency room visits also dropped only
negligibly by 12 percent and outpatient hospital care visits went up by 14
percent during the period along with outpatient costs.
This study underscores concerns Dr.
Weiss and the Asthma and Allergy Foundation of America have about the treatment
regimen many patients are receiving. Beginning in 1989, there was growing
agreement in the medical community that regular daily doses of anti-inflammatory
drugs allowed most asthma patients to control their conditions and thus head
off frequent attacks and more serious, long-term complications. Indeed, that
standard of treatment was codified in 1991 in the National Heart, Lung and
Blood Institute's "Guidelines for the Diagnosis and Management of Asthma."
Nevertheless, according to Dr. Weiss,
studies showed that anti-inflammatory medications represented less than 10
percent of all prescriptions for asthma patients in 1994, when they should
have been at around 30 percent. Preliminary work to determine costs of asthma
data for 1998, he said, suggests that we are still short of that mark.
"This may suggest that many patients
are still not getting the right medications, too often only treating their
symptoms and not the underlying inflammation," Dr. Weiss said.
According to researchers, the states
with the highest total costs of asthma are: 1) California; 2) Texas; 3) New
York; 4) Florida; 5) Pennsylvania; 6) Illinois; 7) Ohio; 8) Michigan; 9) New
Jersey; 10) Georgia.
The study is based on data from the
National Center for Health Statistics. Costs of asthma data is also available
online at www.aafa.org/highcosts for all 50 states and counties with
populations exceeding 100,0000. The same authors of the national costs of
asthma study prepared the state and county breakdowns.
For more information about and reprints
of the study, contact Colleen Horn at 202-466-7643, ext. 225, or by visiting
AAFA's website at www.aafa.org/highcosts
Update from the California Department
of Health Services regarding the Childhood Asthma Initiative's Request for
Applications. The funding for the Initiative was provided to DHS by the California
Children and Families Commission.