This article appears in Spring Healthy Living 2018.

People with asthma know it’s expensive to treat, but others may be surprised at the whopping costs not only to individuals but to society. Between medical expenses and lost productivity due to missed work and school days, asthma costs the U.S. economy more than $80 billion annually, according to new research published online in the Annals of the American Thoracic Society.

While $80 billion is significant, it’s also an underestimate, said Dr. John Mastronarde, a pulmonologist and lead developer of the Oregon Clinic’s Asthma Center at Providence Portland Medical Center. The study analyzed data between 2008 and 2013, which is before newer biological drug therapies for asthma came on the market. While they offer life-altering solutions for people with severe asthma, these newer drugs come with a higher price tags and can add between $35,000 and $40,000 a year in costs, Mastronarde said.

“It’s tough because drugs are expensive,” he said.

“The cost of asthma is one of the most important measures of the burden of the disease,” said Dr. Tursynbek Nurmagambetov, lead study author and health economist at the Centers for Disease Control and Prevention.

The number of people with asthma is increasing every year, said allergist Dr. Bradley Chipps, president of the American College of Allergy, Asthma and Immunology. About 26 million Americans — or 1 in 12 — have asthma, Chipps said. It’s the leading cause of absences from school and work. There is no cure, but effective — if costly — treatments are available, Chipps said.

Comparison-shop

Many asthma sufferers prefer the convenience of an inhaler, but people often don’t realize that the cost of inhalers can vary greatly within a community, Mastronarde said. The price can be lower or higher at pharmacies in drug, grocery, big box and other stores.

“It pays to shop around. If you can’t find prices online, pick up the phone, call and ask. Be persistent,” Mastronarde said.

In addition to using generics when possible, people should comparison-shop on sites like NeedyMeds.org and GoodRX.com, Mastronarde said. NeedyMeds offers discounts and lists hundreds of programs that give away billions in medications every year to people who are eligible. The nonprofit considers a person’s income, insurance status and diagnosis. GoodRX is a comparison-shopping site that offers coupons to be used at brick-and-mortar stores.

Look north

While pharmaceutical costs skyrocket in the United States, many Americans turn to online Canadian pharmacies to fill their prescriptions and buy inhalers.

“Order medicine from Canada,” Chipps said.

Get a good fit

Read the fine print on your insurance plan, and talk with your doctor to make sure you’re getting the most cost-effective drug that your plan offers, Mastronarde said.

“Is there another drug that is less expensive but offers the same efficacy?” Chipps said.

Nebulizer versus inhaler

For seniors with Medicare Part B, nebulizers and nebulizer solution are free, Chipps said. Nebulizers can do almost everything an inhaler does except they work more slowly, he said.

Perfect technique

Revisit your inhaler technique at every doctor visit to be sure you’re using it effectively, Chipps said. People forget the proper method or just get lazy, he said.

Develop healthy habits

“It’s just common sense that you should eat right, exercise and take care of your health,” Chipps said.

Make sure you take care of your nose and sinuses because seasonal allergies can affect your asthma.

“As the upper airways go, so goes the chest,” Chipps said.

Stop smoking

About 20 to 25 percent of people with asthma smoke, which makes asthma worse and reduces the effectiveness of inhalers, Mastronarde said.