US health care spending on respiratory conditions has increased dramatically in recent years

US health care spending on respiratory conditions, particularly chronic conditions such as asthma and COPD, rose dramatically from 1996 to 2016, researchers reported in American Journal of Respiratory and Critical Care Medicine.

“The US spends more on health care than any other country in the world, with no better results. Expenses for respiratory diseases are no exception. Kevin I. Duan, MD, MS, from the division of pulmonary, critical care and sleep medicine at the University of Washington and the Center for Innovation in Veteran-Centered Care and from Value at the VA Puget Sound Care System, Seattle and colleagues wrote. “However, currently available estimates of respiratory disease expenditure, while providing an important starting point, provide an incomplete picture due to limitations.”

The researchers used data from the Institute for Health Metrics and Evaluation’s Disease Expenditure Project database of annual estimates of expenditures for 38 age and sex groups, seven types of care, and three types of payers.

The researchers focused on health care spending from 1996 to 2016 for 11 respiratory conditions:

• asthma;
• COPD;
• interstitial lung disease and sarcoidosis;
• lower respiratory tract infections;
• pneumoconiosis;
• smoking intervention;
• cancer of the trachea, bronchi and lungs;
• tuberculosis;
• upper respiratory tract infections;
• whooping cough; AND
• other chronic respiratory diseases.

In 2016, total spending for all respiratory conditions was $170.8 billion, an increase of $71.7 billion from 1996. This represented an annual growth rate of 2.7%.

In 2016, the highest expenditures in the US were for asthma ($35.5 billion) and COPD ($34.3 billion) followed by lower respiratory tract infections ($32.2 billion) and upper respiratory tract infections ($12.6 billion dollars). Expenditure on asthma contributed to 20.8% of all respiratory disease expenditure and expenditure on COPD contributed to 20.1%. For asthma, the most expensive type of care was pharmaceutical drugs, which accounted for $17 billion (48%) of all spending. For COPD, pharmaceutical ($9.8 billion) and hospital care ($9.9 billion) expenditures were similar for both types of care, contributing 57.3% of all COPD expenditures.

The increase in price and intensity of service was accompanied by an increase of 50.4 billion dollars (81.4%) from 1996 to 2016.

“In summary, US health care spending on respiratory conditions increased significantly from 1996 to 2016,” the researchers wrote. “Expenditure growth was more associated with higher price and service intensity, which supports policy reforms targeting prices as an important approach to curb spending growth.”