Asthma: an $825 million burden to NZ

By REBECCA WALSH and KATHERINE HOBY

Asthma sufferers are entering hospital at more than double the rate of 30 years ago, prompting calls for the Government to take their condition more seriously.

A report released today by the Asthma and Respiratory Foundation of New Zealand has found severe asthma more common than previously thought.

Up to 8 per cent of teenagers reported wheeze-limiting speech and 10 per cent of adults reported waking with breathlessness in the past 12 months.

New Zealand has one of the highest rates of asthma in the world. One in six New Zealanders has the disease and it is the most common cause of hospital admissions for children.

The report has calculated that the cost to the country, not only of treatment but of lost working time, disability and premature death, is at least $825 million a year, double previous estimates.

Although the number of asthma deaths has fallen, one in every 200 deaths is attributable to the condition.

Asthma has a significant impact on sufferers' quality of life.

Among males, it is the country's worst specific disease on a measure of years lost to disability (periods in which a person is too unwell to enjoy a productive, normal life).

Among females, it is the third worst.

Asthma Foundation medical director Professor Ian Town said the study provided compelling evidence that the Ministry of Health needed to take the condition more seriously.

"Asthma isn't currently a priority for the ministry," he said.

"It has a huge impact on people's well-being and is a significant economic cost to our society. We know there are strategies that will reduce the burden of asthma to individuals and the country as a whole. What we need now is commitment to invest in them."

The report, titled The Burden of Asthma in New Zealand, was partly financed by an educational grant from the drug company GlaxoSmithKline.

Researchers Dr Shaun Holt and Professor Richard Beasley found hospital admissions for asthma reached 9405 in the year to June 30, 1999. That was more than twice the rate of the 1960s and 1970s.

One of the main causes of the high hospitalisation rates was the expense of seeing a doctor regularly.

A possible solution, Professor Town believes, is an annual asthma check programme such as that provided for diabetics.

He said he would meet Health Minister Annette King to discuss issues surrounding the funding and management of asthma.

He was also keen to discuss with her a recent Australian initiative aimed at better understanding the condition in that country.

The $48 million federally financed "three-plus" system is aimed at getting three regular annual checks for asthmatics.

Mrs King said the report raised some valid points.

"It's fair enough that they're disappointed but it doesn't mean we're doing nothing. We spent something like $53 million on asthma drugs last year."

Mrs King said she believed the foundation was upset that asthma was not listed as one of the "big 13" priorities on the New Zealand Health Strategy, revealed in 2000.

But she said it was listed under three of the priorities - Maori and Pacific Island health, child health and the smoking strategy.

She said there was a need to be realistic about spending.

"Our priorities at the moment are around cardiac disease, cancers and diabetes.

"There are some things we have got to do now and some have a longer time frame."

Although the prevalence of asthma was similar for Maori and non-Maori children (20 per cent of children aged 6 to 14 have asthma), the rate of asthma in adults was higher for Maori (22 per cent) than non-Maori (15 per cent).

Asthma was also more common among Pacific Island adults (20 per cent).

The report said Maori and Pacific Island children tended to have more severe asthma and hospital admissions were twice as high for Maori than non-Maori.

It said the most likely explanation for the disparity was the inequality of access to primary healthcare.

Professor Town said access to adequate primary healthcare needed to be improved urgently.

"A good solid framework of care is needed. Sufferers need to have access to GPs, to medications, to education and to instruction about asthma," he said.

The foundation wanted to see a more integrated approach to managing asthma, including education and provision of written asthma plans.

It recommended establishing regional advisory groups to help district health boards plan and co-ordinate services for people with asthma and related respiratory conditions.

Factors such as diet, climate, immunisation rates, economic conditions, community health standards, antibiotic use and the timing and number of respiratory infections in early life are being studied to try to determine why people develop asthma.

Direct medical costs, such as pharmaceuticals, patient care and specialist services, accounted for $125 million of the estimated total cost to the country.

Indirect costs such as days of work lost and loss of healthy life because of disability and premature death accounted for a further $700 million.

nzherald.co.nz/health