Asthma management: curtailing costs and improving patient outcomes.

As our understanding of asthma has evolved, so have pharmaceutical strategies for managing this disorder. Once considered a disorder of airway smooth muscle, asthma now is regarded primarily as a chronic inflammatory disorder of the airways. Traditional therapy sought to suppress bronchoconstriction and other signs and symptoms of asthma when they occurred, but contemporary strategies center on managing the underlying inflammation through long-term medications intended to reduce the overall risk of acute attacks. Direct and indirect costs of illness for asthma were estimated at $6.2 billion in 1990. Undoubtedly the costs are considerably higher today due to the increasing prevalence of the disorder. The costs associated with the illness are not distributed evenly among the 15 million Americans with asthma. About 20% of the patients account for 80% of the expenditures. By identifying the high-cost patients and educating them regarding the proper use of medication, it may be possible to curtail costs associated with asthma. Healthcare professionals, especially in their role as educators, are critical to reducing morbidity, mortality, and costs associated with asthma patients.