BibTex format
@article{Lim:2025:10.1016/j.waojou.2025.101146,
author = {Lim, LHM and Juang, YR and Chotirmall, SH and Tan, KB and Koh, MS and Abisheganaden, JA and Price, DB and Tsai, MJ and Liew, MF and Tiew, PY and Yii, ACA and Chen, W},
doi = {10.1016/j.waojou.2025.101146},
journal = {World Allergy Organization Journal},
title = {Economic burden of asthma multimorbidity in Singapore: Shadow costs of steroid use},
url = {http://dx.doi.org/10.1016/j.waojou.2025.101146},
volume = {18},
year = {2025}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background In some countries including Singapore, biologic therapies are not routinely available. Instead, oral corticosteroid (OCS) is commonly used for severe asthma management, which could lead to substantial adverse health events. Objective To estimate the multimorbidity costs in asthma patients from a multi-ethnic Asian population. Methods We examined national health administrative data (2012–2019) from Singapore. Direct medical costs were summed from costs of hospitalisation, emergency department (ED), specialist care, and public primary care. Prescription data were not available but formed part of public primary care costs. We measured cost per patient-year (PY) in 2023 Singaporean dollars (SGD$1 = US$0.76 = 0.60 = €0.69). We performed propensity-score matching on asthma and non-asthma patients, and applied generalised linear models to estimate total and excess costs due to asthma, OCS-related comorbidities, and other comorbidity groups. Results We identified 19,979 paediatric and 48,237 adult asthma patients (48.2% males, 50.4% Chinese, 13.9% Indian, 26.8% Malay), and matched equal number of non-asthma patients. Paediatric and adult asthma patients respectively incurred $816.3/PY (95% CI: $803.0/PY-$829.5/PY) and $1855.9/PY (95% CI: $1845.0/PY-$1871.0/PY) in total costs. The average ($1610.9/PY [95% CI: $1599.5/PY-$1621.3/PY]) was thrice of non-asthma patients’ ($530.4/PY). Excess costs (mean = $927.2/PY) were driven by asthma ($403.0/PY), OCS-related comorbidities ($104.0/PY), other metabolic disease ($116.4/PY), circulatory diseases ($112.9/PY) and non-asthma respiratory conditions ($107.4/PY). All excess cost components increased steadily over the 8-year study period. Conclusion The burden of asthma multimorbidity in Singapore is severe, with a considerable fraction attributable to OCS-related comorbidities. Policies should aim to reduce excess OCS use and enhance integrated multimorbidity management.
AU - Lim,LHM
AU - Juang,YR
AU - Chotirmall,SH
AU - Tan,KB
AU - Koh,MS
AU - Abisheganaden,JA
AU - Price,DB
AU - Tsai,MJ
AU - Liew,MF
AU - Tiew,PY
AU - Yii,ACA
AU - Chen,W
DO - 10.1016/j.waojou.2025.101146
PY - 2025///
TI - Economic burden of asthma multimorbidity in Singapore: Shadow costs of steroid use
T2 - World Allergy Organization Journal
UR - http://dx.doi.org/10.1016/j.waojou.2025.101146
VL - 18
ER -