Corticosteroid-induced morbidity in asthma: costs and consequence

This thesis aims finally to explore the socioeconomic context within which this burden occurs through the use of a measure of stress-related “wear and tear” called allostatic load. This potentially avoidable burden is explored using a number health and social databases from the UK.<br><br>This thesis provides estimates of the cost of corticosteroid-induced morbidity for individuals with severe asthma relative to those with mild/moderate asthma and no asthma in the UK.

This cost is much larger than estimates used to inform the cost-effectiveness of novel corticosteroid-sparing therapies in the UK and is consistent with other research published in the intervening period. It is shown that this burden is not evenly spread across the life course. Corticosteroid exposure potentially “brings forward” the expression of many comorbidities common in asthma suggesting younger individuals may benefit most from increased access to these expensive therapies.

Finally this notion of early aging in relation to corticosteroid exposure is put in context in relation to the Grossman model for the demand for health and implications discussed.