UAE needs to address increasing cost of asthma, doctors warn

An estimated 60 million people are at risk in the Middle East of developing some kind of respiratory illness in their lifetime, mainly as a result of smoking, extreme weather variations, dust storms and genetics.

DUBAI // Doctors are facing a challenge to control increasing numbers of asthma cases and respiratory illnesses as treatment fees and lost working hours alone cost Dubai almost Dh88 million a year.

An estimated 60 million people in the Middle East are at risk of developing some kind of respiratory illness in their lifetime, mainly as a result of smoking, extreme weather variations, dust storms and genetics.

A study into the cost of asthma on the Dubai economy, completed in 2014 but discussed this week, showed that it cost the emirate Dh87.92m a year in lost working hours and treatment for sufferers.

In Dubai, 50 per cent of children who suffered from asthma missed school days, and workers with the condition on average took four days a year off work because of the condition.

Speaking at a regional respiratory forum hosted by pharmaceutical company Boehringer Ingelheim, Rashid Hospital’s head of pulmonary medicine, Dr Bassam Mahboub, said most sufferers were under 40.

“Our data suggests that across the Mena region, about 40 million individuals are suffering from multiple respiratory diseases,” he said.

“Sixty to 70 per cent of patients who have a respiratory illness diagnosed are under the age of 40, where smokers make up 30 per cent of the patients. So 60 million people across this region alone are strong candidates for developing respiratory diseases.”

Asthma prevalence and cost estimates were applied to the population of Dubai aged 5 years and above, based on figures from the Dubai Statistic Centre’s 2009 census.

Patient treatment profiles, days absent from school or work and quality of life data were obtained from the Asthma Insights and Reality for the Gulf and Near East study, part of a global survey to assess asthma control. The purchase department of Dubai Health Authority provided researchers with costs of drugs and outpatient visits, as well as hospital stays and emergency visits.

In 2014, outpatient visits cost Dh32,217,143, and bills for hospital stays reached Dh23,587,008. Medication and E R visits represented 20 per cent and 16 per cent respectively of the direct cost.

Chronic obstructive pulmonary disease is a respiratory illness that represents a major health concern for developing countries and is ranked as the fourth leading cause of death worldwide. It is expected to become the third leading cause by 2030.

“Smokers usually visit their doctor to see about heart problems or if they have cancer,” Dr Mahboub said.

“They are totally, absolutely clueless about COPD. Smokers are usually not aware of the prevalence of COPD.”

According to the World Health Organisation, contributing risk factors of COPD include tobacco smoking, indoor and outdoor air pollution and exposure to occupational dusts and chemicals.

About 3.7 per cent of the UAE population suffers from COPD, according to a 2011 study by Zayed Military Hospital. The condition is a progressive disease that makes it hard to breathe and can only be controlled by treatment.

Speaking at the Dubai forum, British respiratory specialist Dr David Halpin said the impact of breathing problems should not be underestimated by regional health authorities.

“The impact of asthma in the Mena region is heavy,” he said. “It requires immediate action especially to increase awareness and overall understanding of chronic respiratory diseases among healthcare workers, healthcare providers and governments.

“It is important for health authorities across the region to develop national strategies and action plans to improve asthma management and reduce costs, while also ensuring availability of national appropriate asthma management guidelines.”

Dr Ahmed Alhaj Saleh, a consultant of internal medicine at Medeor 24x7 Hospital, Dubai, said a key challenge faced by doctors was finding ways to treat asthmatics that could help to reduce costs.

“In diabetes treatment, we have many options, but that isn’t the case with asthma,” he said.

“Asthma is a chronic problem and we have a limited group of medications at our disposal.”