ABSTRACT
Public and private health care systems are developing methods to minimize the cost of managing chronic diseases while maintaining a high quality of care for their member populations. The goals of minimizing cost and ensuring quality often are in conflict, particularly in an era of budget constraints. Tension arises because public and private coverage of health care creates incentives for patients (and often providers) to consume care with little regard for the unit price of that care. As a consequence, decision makers are finding themselves in new roles as managers of disease management strategies that balance the need for fiscal responsibility with patients’ desire to obtain the most technologically advanced and beneficial care that is available. Because the process of allocating scarce resources among competing medical treatments can be emotional and politically charged, decision makers prefer to adopt rational, standardized tools for economic evaluation which are designed to maximize health for a given level of medical care expenditure. Health
The rising cost of asthma care, however, is at odds with moves to tighten health care budgets. Asthma has been the target of intense activity in the areas of clinical practice guidelines, disease management, drug formulary design and other efforts that are at least in part aimed at reducing medical expenditures and increasing quality for asthma care. Because asthma has become such an important topic to the public, decision makers must be mindful of the social as well as clinical aspects of this disease in their efforts to control the costs of asthma care. Since economic evaluations combine a societal perspective with analysis of clinical and economic effectiveness, this methodology holds great promise as an aid to therapeutic decision making for populations of patients with asthma.
