Table of ContentsView AllTable of ContentsCost of Asthma CareHidden CostsImprovementsFiling for DisabilityRacial DisparitiesFAQs
Table of ContentsView All
View All
Table of Contents
Cost of Asthma Care
Hidden Costs
Improvements
Filing for Disability
Racial Disparities
FAQs
This article is part ofHealth Divide: Asthma in People of Color, a destination in our Health Divide series.
Access to healthcare is not equal in the United States, which is true for adults and children living withasthma. Black, Latinx, and Indigenous people bear the highest burden of asthma in the U.S. and higher rates of asthma death.Black communities are at especially high risk due to unequal access to health care, structural racism, and a historic distrust in the health care system.
The cost ofasthma medicationsplays a central role in these disparities. Fortunately, there are resources to reduce these costs, including financial assistance programs and generic versions of approved asthma medications.
This article outlines the costs of asthma care in the United States today, including its effect on productivity and quality of life and why certain communities are disproportionately affected.
Zoe Hansen / Verywell
Costs Associated With Asthma Care
According to an analysis from the Centers for Disease Control and Prevention (CDC), the annual per-person cost of asthma care in the United States was $3,266 (in 2015 dollars).
Not surprisingly, the per-person annual cost of asthma care among uninsured people was 35%less($2,145) than the national average—mainly due to affordability and unequal access to care.
With Insurance
Despite improved access to health care under theAffordable Care Act (ACA), studies suggest that having a lower income reduces a person’s ability to maintain asthma control. This is true despite their insurance status.
In fact, a 2022 study found that low-income individuals with asthma who accessed care through the ACA did not experience significant changes in their asthma control. In total, 22% and 31% of the 4,043 people included in the study reported problems affording their medications and medical visits, respectively.
According to the CDC analysis, people with asthma are more likely to have health insurance than those without asthma, due in large part to the need for ongoing care and treatment. Even so, many insured people struggle with the cost of care, whether it’s due to the price of medications or the cost of seeing a primary care provider or anasthma specialist.
Among adults with full health insurance coverage, one in eight report problems affording asthma care. Among those with partial or no coverage, nearly half struggle with affordability.
While having insurance generally improves health outcomes in people with asthma, not everyone benefits equally. A bigger factor appears to be a family’s annual income.
While the Affordable Care Act reduced the uninsured rate among people withairway diseaseslike asthma from 19.4% in 1997 to 9.6% in 2018, it neither improved affordability nor health disparities.
Without Insurance
Having no insurance almost invariably leads to poorer outcomes in people with asthma. Numerous studies have shown a direct association between the lack of insurance and the increased frequency of emergency room visits among people with asthma. What may surprise you is that it seems to have the opposite effect in terms of hospitalizations.
What this suggests is that uninsured people without continuous care for their asthma may have no other option but to go to an emergency room when they have an attack.
Regarding health care in the United States, communities of color are disproportionately affected. Black and Latinx people are especially more likely to seek emergency care for asthma than White people.
How Asthma Is Treated
Hospital Bills
The hospital bill for one severe asthma event can be staggering. According to a 2014 report from the Agency for Healthcare Research and Quality (AHRQ), the average cost of an asthma-related hospitalization from 2000 to 2010 was $3,600 for children and $6,600 for adults.
The AHRQ also reported that the rate of asthma-related admissions was more than three times higher among Black children and two times higher among Black adults than for their White counterparts.
For some patients, the costs may be far greater. A 2015 study that included all ages found an average length of stay for asthma-related hospital admissions was 3.9 days at a cost of $6,688. Ifmechanical ventilation(machines that take over the work of breathing) was needed, the stay was increased to 8.3 days and $21,556 (in 2015 dollars).
Hospitalization DisparityThe rate of asthma hospitalizations among Black adults is three times that of White adults, while the rate among Black children is more than five times that of White children.
Hospitalization Disparity
The rate of asthma hospitalizations among Black adults is three times that of White adults, while the rate among Black children is more than five times that of White children.
Breathing Tools
Inhaled asthma medications, includinginhaled steroidsandlong-andshort-acting bronchodilators, remain the mainstay of asthma treatment. For most people with asthma, the drugs account for the majority of out-of-pocket costs.
According to data fromMedicare, the most money spent on asthma inhalers today is forcombination inhalersthat contain both a long-acting bronchodilator and a steroid.
The average wholesale price (AWP) for these combination inhalers is as follows:
The AWP does not reflect the cash price that people without insurance have to pay at checkout. Every state has different ways of calculating these prices and dispensing fees, both of which increase out-of-pocket costs.
These issues affect many communities of color that tend to have higher rates of poverty and unemployment. Studies have shown that uninsured and partially insured Black people are nearly twice as likely as White people to report drug affordability as a barrier to asthma care for their kids.
Why Are Inhalers So Expensive?
15 Inhalers for COPD
Other Hidden Costs
Over 25 million people in the United States are currently diagnosed with asthma.In 2017, more than 11 million people in the United States reported having at least one asthma attack in the prior 12 months. Of these events, there were 1.8 million emergency room visits, nearly 200,000 hospitalizations, and about 3,500 deaths.
With that said, the cost of asthma extends well beyond even these dire statistics, reducing productivity and the quality of life of those affected.
Missed Time at Work or School
According to a 2019 study,the United States is expected to spend over $300 billion on direct costs associated with asthma through the year 2038.This doesn’t take into account indirect costs like reduced job productivity, the cost of which is no less staggering.
You don’t have to look 20 years ahead to note the impact of asthma on a person’s productivity. A 2020 studyreported that the annual indirect cost of lost productivity was significantly higher among people with partly controlled asthma ($10,448) and poorly controlled asthma ($14,764) than those with well-controlled asthma ($6,353).
Effect on Quality of Life
Achieving asthma control is associated with improvements in a person’s quality of life, better work performance, and reduced medical costs. But the reality is that many at-risk populations are unable to achieve these goals, including Black people ages 18 to 29, who tend to have poorer outcomes and lower rates of treatment adherence.
The loss of quality of life can be especially impactful in people with uncontrolled asthma in different ways, including:
Asthma and Depression
How to Cope and Live Well With Asthma
Discussing Affordability With Your Healthcare Provider
The affordability of asthma treatment is one of the major barriers to controlling the disease over the long term.
Ask About Generic Medications
While there are many asthma drugs whose patents grant them a period of exclusivity—and invariably higher prices—there are several whose patents have expired and are now available as generics.
These include lower-cost generics of the following brand name asthma drugs:
Are Generic Asthma Inhalers Good?
Look Into Financial Assistance
Manufacturers of some of the pricier asthma medications offer financial assistance programs for qualified individuals. Among them:
There are also nonprofit organizations like thePatient Advocate Foundation(PAF) that grant annual awards to assist with asthma drug copayments.
Patient Assistance Programs for Asthma Medication
Where to Find Discounts
Prices can vary for asthma medications from one pharmacy to the next, sometimes significantly. It often pays to shop around for the best prices or to use an online price comparison tool like GoodRx orNeedyMeds.
GoodRx also helps you find coupons from a comprehensive list of participating pharmacies. Similar discount coupons are available from free programs likeOptum Perks, SingleCare, andScriptSave WellRx,and subscription programs likeBlink Health.
Filing for Disability With Asthma
If your asthma is severe enough that you cannot work, you may be qualified for a monthly Social Security Disability Insurance (SSDI) benefit. These benefits are intended for people who are totally disabled and unable to work for a year or more because of their disability.
Severe asthma is considered a qualifying medical condition.When you apply, you must show that you have beendiagnosed with asthmaand that your asthma is severe enough to prevent you from obtaining gainful employment.
How to Apply for Social Security Disability
The burden of asthma falls disproportionately on Black, Latinx, and Indigenous people. These groups have the highest rates of asthma, asthma hospitalizations, and asthma-related deaths of all other racial or ethnic groups in the United States.
Compared to White people, Black and Latinx people are 150% and 200%, respectively, more likely to have asthma. This is due in large part to pollution inequity in the United States wherein Black and Latinx communities are 56% and 63%, respectively, more likely to be subject to excessive air pollution (considered a major risk factor for asthma).
There are also unique factors contributing to health disparities in the Black, Latinx, and Indigenous populations.
Asthma Diagnosis Barriers for People of Color
Black People With Asthma
As a result, Black women with asthma are today the group with the highest rate of asthma-related deaths of all racial or ethnic populations.
Latinx People With Asthma
Among Latinx people, 27% report having no access to consistent health care compared to 17% of White people. Lower rates of post-secondary education compared to White people (29% vs. 45%) impact health knowledge and literacy. Language barriers and lower rates of Latinx healthcare workers further impact the quality of care in hospitals and clinics.
As a result, Latinx people are three times more likely to die from asthma than White people and twice as likely to have asevere asthma attack.
Indigenous People With Asthma
Among Indigenous people in the United States, 24% of American Indians and Alaska Natives live below the poverty threshold. Compared to their White counterparts, Indigenous adults and youth are 30% and 50%, respectively, more likely to haveobesity(another major contributing factor to asthma).
As a result of these and other issues, Indigenous people are twice as likely to have daily asthma attacks compared to White people and more likely to experience mental health problems as a result.
Summary
Asthma does not affect all groups equally. In the United States, people of color have higher rates of asthma and also are more likely to be hospitalized, need emergency care, and die because of the disease.
Unequal access to health care and insurance, as well as the high cost of inhaled asthma medications, contributes to this disparity. But there are other unique social, cultural, and economic factors that influence asthma in each of these at-risk groups, including structural racism, discrimination, and language barriers.
Despite the barriers, there are ways to access treatment through manufacturer assistance programs, copay assistance programs, discount coupons, and switching from brand-name drugs to less expensive generic options. If asthma is severe enough that you can no longer work, you may qualify to file for Social Security Disability Insurance (SSDI) benefits.
A Word From Verywell
Fearing the high cost of asthma care can deter some people from seeking treatment. Untreated asthma can lead to a variety of health complications, so it’s important find accessible treatment options. Fortunately, there are several assistance programs available to make the cost of asthma treatment more affordable. Discuss these options with your healthcare provider to ease the financial burden while maintaining your health.
Frequently Asked Questions
Higher rates of poverty and lower rates of health coverage in communities of color influence a person’s ability to afford asthma care and maintain asthma control. As result, people of color are far more likely than White people to have poor asthma control and to regard affordability as a major barrier to care.
In addition to accessing low-cost generics or prescription assistance programs, parents with low incomes should see if they qualify forMedicaidor the Children’s Health Insurance Program (CHIP). Both offer free or low-cost health coverage for kids and teens up to age 19.You can apply any time of year. If you qualify, coverage starts immediately.Learn MoreMedicaid or CHIP: Which Is Better?
In addition to accessing low-cost generics or prescription assistance programs, parents with low incomes should see if they qualify forMedicaidor the Children’s Health Insurance Program (CHIP). Both offer free or low-cost health coverage for kids and teens up to age 19.You can apply any time of year. If you qualify, coverage starts immediately.
Learn MoreMedicaid or CHIP: Which Is Better?
23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Asthma and Allergy Foundation of America.Asthma disparities in America, 2020.
Nurmagambetov T, Kuwahara R, Garbe P.The economic burden of asthma in the United States, 2008-2013.Ann Am Thorac Soc. 2018;15(3):348-56. doi:10.1513/AnnalsATS.201703-259OC
Suri R, Macinko J, Inkelas M, Needleman J.The relationship between insurance status and the Affordable Care Act on asthma outcomes among low-income US adults.Chest.2022;S0012-3692(22)00046-0. doi:10.1016/j.chest.2022.01.011
Centers for Disease Control and Prevention.Insurance coverage and barriers to care for people with asthma.
Gaffney AW, Hawks L, Bor D, et al.National trends and disparities in health care access and coverage among adults with asthma and COPD: 1997-2018.Chest. 2021;159(6):2173-82. doi:10.1016/j.chest.2021.01.035
Lin MP, Vargas-Torres C, Schuur JD, Shi D, Wisnivesky J, Richardson LD.Trends and predictors of hospitalization after emergency department asthma visits among U.S. adults, 2006-2014.J Asthma.2020;57(8):811–9. doi:10.1080/02770903.2019.1621889
Agency for Health Statistics and Quality.Statistical brief #169: trends in pediatric and adult hospital stays for asthma, 2000–2010.
Kaur BP, Lahewala S, Arora S, Agnihotri K, Panaich SS, Secord E, Levine D.Asthma: hospitalization trends and predictors of in-hospital mortality and hospitalization costs in the USA (2001-2010).Int Arch Allergy Immunol.2015;168:71-8. doi:10.1159/000441687
U.S. Department of Health and Human Services.Asthma and African Americans.
Thomas A, Haddad I, Hoskere G.Trends in inhaler prescriptions and associated cost in the United States from 2014 to 2018: an analysis from the Medicare Part D database.Cureus.2021;13(2):e13498. doi:10.7759/cureus.13498
Jena AB, Ho O, Goldman DP, Karaca-Mandic P.The impact of the US Food and Drug Administration chlorofluorocarbon ban on out-of-pocket costs and use of albuterol inhalers among individuals with asthma.JAMA Intern Med. 2015;175(7):1171–9. doi:10.1001/jamainternmed.2015.1665
Centers for Disease Control and Prevention.Most recent national asthma data.
Nurmagambetov TA, Krishnana JA.What will uncontrolled asthma cost in the United States?Am J Respir Crit Care Med.2019;200(9):1077–8. doi:10.1164/rccm.201906-1177ED
Yaghoubi M, Abidi A, Safari A, Fitzgerald JM,The projected economic and health burden of uncontrolled asthma in the United States.Am J Respir Crit Care Med.2019;200(9):1102–12. doi:10.1164/rccm.201901-0016OC
Lee LK, Ramakrishnana K, Safioti G, Ariely R, Schatz.Asthma control is associated with economic outcomes, work productivity and health-related quality of life in patients with asthma.BMJ Open Respir Res.2020;7(1):e000534. doi:10.1136/bmjresp-2019-000534
MacDonell KK, Dailey R, Gibson-Scipio W, Wang B, Dinaj-Koci V, Bruzzese M.Exploring barriers to medication adherence among African American emerging adults with uncontrolled asthma.Health Educ Behav. 2021;10901981211001345. doi:10.1177/10901981211001345
Hossny E, Carabello L, Casale T, El-Gamal Y, Rosenwasser L.Severe asthma and quality of life.World Allergy Organ J.2017;10(1):28. doi:10.1186/s40413-017-0159-y
Akula M, Kulikova A, Khan DA. Brown ES.The relationship between asthma and depression in a community-based sample.J Asthma.2018;55(12):1271–7. doi:10.1080/02770903.2017.1418885
Social Security.Disability benefits | How you qualify.
Social Security.Disability evaluation under Social Security: 3.00 respiratory disorders - adult.
Perez MF, Coutinho MT.An overview of health disparities in asthma.Yale J Biol Med.2021;94(3):497–507.
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