The economic cost of asthma in Singapore

Background: Asthma is a common chronic disorder. In Singapore, it is estimated that 140,000 individuals have current asthma and more than 100 individuals die of this disease annually. Objective: This study estimates the economic cost of asthma, both direct and indirect, to the patient and community. Method: Direct cost estimates were based on all levels of medical care, which included inpatient care, emergency room visits, specialist outpatient and primary healthcare, and medication costs. Indirect costs were estimated from cost of time lost by patients and their families attending to medical needs and the loss of productivity due to absenteeism. These estimates were calculated to the 1992/93 US dollar. Results: The total cost of asthma in Singapore was estimated to be US$33.93 million per annum. This was made up of US$17.22 million in direct costs and US$16.71 million in indirect costs. Inpatient hospitalisation accounted for the largest proportion of direct medical expenditure, approximately US$8.55 million. The loss of productivity from acute asthma accounted for the largest proportion of the indirect costs at US$12.70 million. The cost estimates did not include premature death due to disease. These estimates represent approximately US$238 per asthmatic person per year or US$11.90 per person per year. Conclusion: This study shows that the economic cost of asthma is also considerable in populations outside the Western hemisphere, and justifies the need for a concerted effort to reduce asthma morbidity worldwide.