Asthma is a common chronic disease that places substantial economic, social, and public health burdens on society. According to the Centers for Disease Control and Prevention, the prevalence of asthma has increased significantly during the years 1980-1999.¹ Morbidity from asthma also has been increasing, with a 17% increase in the overall hospitalization rate for adults and a 53% increase in the hospitalization rate for children from 1980-1999. During this time period, mortality from asthma also increased by approximately 61%.¹

The cost of asthma is substantial. Individual cost estimates range from $300 to $1300 per patient per year.² The financial burden for all forms of asthma totals $14 billion annually, with $9.4 billion in direct costs and $4.6 billion in indirect costs.³ Moreover, these figures continue to increase despite significant investment of resources within managed care, including asthma disease management models, case management, population health initiatives, and recently imposed pharmacy-based adherence protocols.

Challenges abound with early and accurate diagnosis, effective and appropriate treatment, compliance with prescribed therapeutic regimens, comorbidities that limit response to treatment, and increasing barriers to effective asthma care. Numerous studies have shown that a large proportion of patients fall short of ideal asthma treatment goals.^4-6 Guidelines exist to assist physicians in the management of asthma, but they are underutilized due to their size and complexity.

The magnitude of the health-related and fiscal consequences of asthma in the United States, along with problems with maintaining effective asthma treatment and management, suggest that improved education regarding this disease is necessary. Novel therapies and methods to treat and monitor patients with asthma, as well as rapidly evolving guidelines and standards of care leading to behavior change, require ongoing education that is focused and rigorous in its design. Such education would help to improve the quality of life of the patient with asthma, decrease morbidity and mortality, and reduce the number of unnecessary or emergency healthcare visits.

Improving outcomes in patients with asthma is a multidimensional process in managed care that requires a well-planned asthma management approach. This supplement to The American Journal of Managed Care addresses patient factors, most notably nonadherence, because patients who comply with treatment therapy are more likely to keep their asthma symptoms under control. Consistently using asthma guidelines and adopting newly evolved concepts for asthma control have been shown to help improve care for asthma patients.

Understanding the appropriate use of traditional medications, as well as their combined use with novel biologic therapies, is critical to successful management of the patient with asthma. Assisting both patient and provider in carrying out recommended treatment and monitoring is likewise essential to ensure better outcomes for the patient.