Economic impact of steroid-induced comorbidities in severe asthma: a SHARP CRC simulation.

Background: Patients with severe asthma (SA) consume roughly 50% of the global asthma healthcare resources due to unscheduled visits, hospitalisations, therapy and management of oral corticosteroid (OCS)-related adverse events (AEs). Biologics offer a route away from continuous OCS treatment. Asthma management guidelines discourage OCS usage, particularly when continuous and at high doses because of increased risk of OCS-AEs. This study simulates the economic burden over 10 years of reversible OCS-AEs (hypertension, psychiatric conditions, sleep disorders, dyspepsia) in SA patients in 11 European countries. Methods: The focus of this study was exclusively on the economic burden of AEs resulting from continuous OCS use in SA patients. For each country, a budget impact model estimated total AE costs in SA patients in various OCS sparing scenarios. AE costs arising from daily OCS use (reference cost) were compared to AE costs when a percentage of patients annually stops OCS, and the rate of OCS-related AEs decreases. Epidemiological data, OCS-AE prevalence values and costs were literature-based. Results: Analysis showed potential cost reductions of 13.1% to 31.6% in terms of OCS-related comorbidities over 10 years among SA patients. The size of the saving depends on the rate of onset of comorbidity, the reversibility of OCS comorbidities and the proportion of the population stopping OCS each year. Conclusion: Stopping OCS has the potential to yield substantial, long-term AE savings in SA patients.