Allergy Asthma Immunol Res.  2019 Mar;11(2):280-290. 10.4168/aair.2019.11.2.280.

Prescription Patterns and Burden of Pediatric Asthma in Korea

• Sol IS
• Kim YH
• Kim SY
• Choi SH
• Kim JD
• Kim BO
• Moon JE
• Kim KW
• Sohn MH

• KMID: 2431859
• DOI: http://doi.org/10.4168/aair.2019.11.2.280

Abstract

PURPOSE
This study aimed to estimate the prevalence, prescription pattern and burden of pediatric asthma in Korea by analyzing the National Health Insurance (NHI) claims data.
METHODS
We retrospectively analyzed the insurance claim records from the Korean NHI claims database from January 2010 to December 2014. Asthmatic patients were defined as children younger than 18 years, with appropriate 10th Revision of the International Classification of Diseases codes (J45 or J46) and a prescription for 1 or more asthma maintenance medications at the same date. Hospitalization and emergency department visits for asthma were defined as use of short-acting beta2-agonists during hospital visits among asthmatic patients.
RESULTS
There were 1,172,807 asthmatic children in 2010, which increased steadily to 1,590,228 in 2014 in Korea. The prevalence showed an increasing trend annually for all ages. The mean prevalence by age in those older than 2 years decreased during the study period (from 39.4% in the 2-3 year age group to 2.6% in the 15-18 year age group). In an outpatient prescription, leukotriene receptor antagonists were the most commonly prescribed medication for all ages. Patients older than 6 years for whom inhaled corticosteroids were prescribed comprised less than 15% of asthmatic patients. The total direct medical cost for asthma between 2010 and 2014 ranged from $376 to $483 million. Asthma-related medical cost per person reached its peak in $366 in 2011 and decreased to $275 in 2014.
CONCLUSIONS
The prevalence of pediatric asthma increased annually and decreased with age. Individual cost of asthma showed a decreasing trend in Korean children.

Keyword

Asthma; illness burden; child; insurance claims analysis; prescription; prevalence

MeSH Terms

Adrenal Cortex Hormones
Asthma*
Child
Cost of Illness
Emergency Service, Hospital
Hospitalization
Humans
Insurance
International Classification of Diseases
Korea*
Leukotriene Antagonists
National Health Programs
Outpatients
Prescriptions*
Prevalence
Retrospective Studies
Adrenal Cortex Hormones
Leukotriene Antagonists

Figure

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  Fig. 1 Prevalence of asthma in children according to year (A) and age (B). The prevalence showed an increasing trend annually and decreased with age.

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  Fig. 2 The patterns of health care service use with age. The graphs show the mean proportion (A) and numbers (B) of visits by health care service type between 2010 and 2014. Error bars show the minimum and maximum values. OPD, outpatient department; ED, emergency department.

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  Fig. 3 The mean proportions of asthma patients who underwent spirometry and allergy test at least once each year during the study period (2010-2014). Error bars show the standard error.

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  Fig. 4 The patterns of asthma-related medication prescription by age. (A) The number of prescription per person by age. (B) Percentage of asthmatic patients with prescribed asthma medications by age. (C) The number of prescription per person per year. (D) Percentage of asthmatic patients with prescribed asthma medications per year. SABA, short-acting beta2-agonist; ICS, inhaled corticosteroid; LABA, long-acting beta2-agonist; LTRA, leukotriene receptor antagonist.

• 

  Fig. 5 Asthma-related direct costs by age. (A) Cost per patient. (B) The proportion of cost in each subgroup. ED, emergency department; OPD, outpatient department.

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