Document Detail


Exhaled nitric oxide as a tool in managing and monitoring difficult-to-treat asthma.
MedLine Citation:
PMID:  21477457     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Most patients diagnosed with asthma maintain control reasonably well and do not experience asthma exacerbations; however, on average, 30% of patients achieve suboptimal control, have severe or difficult-to-treat asthma, and are relatively nonresponsive to the same medications that achieve and maintain asthma control for most patients. This small patient population ofdifficult-to-treat or severe asthma accounts for 80% of asthma medical costs. This study was designed to determine the potential U.S. payer cost savings resulting from an asthma specialist incorporating fractionated exhaled nitric oxide (FENO) as an asthmamanagement or monitoring tool to guide treatment of difficult-to-treat asthma patients. We present an annual medical resource use scenario typical of a difficult-to-treat asthma patient as well as five hypothetical scenarios of annual medical resource usefor a difficult-to-treat asthma patient being managed with regular FENO measurements in addition to current standard asthma management guidelines. We used the most conservative estimate of the potential asthma cost savings when FENO measurement is used for difficult-to-treat asthma. The most likely clinical scenario assumes a 5% reduction in hospitalization and emergency department costs only. The inclusion of FENO measurements to the asthma management strategy would essentially reach paritywith the current standard of care, despite the additional cost of FENO measurements. Additional scenarios were examined, all showed cost and use reduction across all medical resource usage categories. Use of exhaled NO measurement to guide asthmamanagement, maintenance, and control in difficult-to-treat asthma would almost certainly result in cost savings to the payer.
Authors:
D Bukstein; At Luskin; Ea Brooks
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-8
Journal Detail:
Title:  Allergy and asthma proceedings : the official journal of regional and state allergy societies     Volume:  -     ISSN:  1539-6304     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9603640     Medline TA:  Allergy Asthma Proc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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