Late Breaking Abstract - Modelling the healthcare burden of oral corticosteroid use in France, Spain, and Germany

<bold>Background:</bold> Oral corticosteroids (OCS) are frequently used in the treatment of severe asthma (SA), despite well-established cumulative, chronic complications impacting morbidity and mortality. This study aims to quantify the patient impact and economic burden of OCS complications, as costs to healthcare systems, in patients with SA in France, Spain, and Germany. <bold>Methods:</bold> A health-state transition model was leveraged, incorporating the three OCS complications with the greatest clinical relevance, based on morbidity and mortality, as health states (type 2 diabetes mellitus, cardiovascular disease, osteoporosis). Other complications were captured using a per-cycle risk. Inputs were sourced from the literature (e.g. real-world studies). Populations were matched between arms. Results report the direct cost of OCS complications in SA for total populations and per patient, over a lifetime horizon and taking into account life expectancy. <bold>Results:</bold> The total mean cost in the ‘OCS’ group was €1,025,464,734 greater than the ‘no OCS’ group (€19,063 per patient). Country-specific differences were due to different costs for treating complications, societal inputs, and OCS dosage. <bold>Discussion:</bold> A significant economic burden is associated with SA patients treated with OCS. This could be reduced through the use of OCS sparing strategies, aligned to recent international calls and guidelines for OCS stewardship. <table-wrap><object-id>erj;64/suppl_68/PA3901/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>France</td><td>Spain</td><td>Germany</td></tr><tr><td>Total SA patients on OCS</td><td>51,898</td><td>31,554</td><td>71,882</td></tr><tr><td>Total lifetime cost 'no OCS'</td><td>€8,466,645,235</td><td>€4,905,921,059</td><td>€11,138,767,770</td></tr><tr><td>Total lifetime cost ‘OCS’</td><td>€9,560,230,846</td><td>€5,385,979,777</td><td>€12,641,517,642</td></tr><tr><td>Incremental cost</td><td>-€1,093,585,612</td><td>-€480,058,718</td><td>-€1,502,749,872</td></tr></tbody></table></table-wrap>