Asthma is a major concern for employers. Research out of Harvard Medical School has shown that asthmatics have absenteeism and "presenteeism" (impaired while at work) rates in excess of other, healthier employees. Annual numbers per asthmatic total 10.8 days absenteeism and 18.3 days presenteeism. Combined, those numbers account for nearly 20 work days per asthmatic per year in lost productivity. Uncontrolled or poorly managed asthma also results in emergency room visits and inpatient stays that cost employers even more. It is little wonder, then, that the majority of large employers engage disease management vendors to reach out to asthma patients to encourage them to follow their doctors' recommendations and coach them in better self-management of their condition. Other employers are also engaging lifestyle coaching services. The employer's hope is often that, through early detection via health risk assessment and assistance with lifestyle changes, the asthmatic will be able to lead a personal and occupational life that keeps him or her happy and productive and avoids altogether the serious medical events that trigger disease management efforts in the first place. Gordian Health Solutions offers services that examine lifestyle, behavior, and self-management along with benchmarks that further the goal of helping employers develop specific interventions and wellness programs that foster healthy behavior for asthmatics. In its extensive work over the past 11 years with large national employers, Gordian Health Solutions has accumulated nearly $5 billion in claims data from 61 organizations that can inform this discovery process. And because cost data comes from claims paid by employers, results are very relevant to employers' bottom lines. Gordian also assists physicians in better understanding asthma prevalence rates compared to employer-paid medical (non-pharmaceutical) costs for asthma, with the goal that observed differences will spark innovative treatment ideas. According to the Centers for Disease Control and Prevention, nearly 10 percent of males under the age of 18 are diagnosed with asthma as compared to 7.3 percent for females in the same age group. However, females' risk of asthma increases gradually over their lifetime to 9.6 percent for those aged 55-64, while males' risk decreases sharply with age. Less than 6 percent of men of ages 18-24 have asthma, and less than 5 percent of older men (ages 25 and above) have it. The figures mean that boys are 36 percent more likely than girls to have childhood asthma, but in adults, women have roughly twice the asthma rates of men. But do employers' medical costs for asthma parallel these prevalence rates? Curiously, only the proportion of asthma costs by gender within these age ranges mirror the CDC's findings: Boys account for more than 55 percent of children's asthma costs while women account for as much as 62 percent of adult asthma costs. Looking at men and women separately, however, shows different asthma cost patterns. For example, though middle-aged men have the lowest asthma prevalence (<5 percent), those aged 30-44 account for the highest proportion (28 percent) of all male asthma costs – higher even than boys under 18 (25 percent), whose prevalence rate is twice that of middle-aged men. Most interesting of all might be the asthma cost data that controls for the number of members, i.e., per member per month (PMPM) costs. Males' PMPM medical (non-phar¬m¬a¬¬ceuti¬cal) costs for asthma are in fact inverse their prevalence rates up to age 44 – with steady increases from $2.28 (<18 years) to $3.03 (30-44 years), after which they settle at about $2.68 PMPM. Females' PMPM asthma costs, on the other hand, do mirror their prevalence rates, with relatively low costs for girls and young adults ($1.94) and a steady cost increase with age to $3.12 PMPM for those aged 55-64. The most intriguing and perhaps most relevant finding with respect to employers' attempts at healthcare demand management is that PMPM asthma costs for young men aged 19-29 and 30-44 exceed those of young women by 47 percent and 18 percent, respectively, despite the fact that women's asthma prevalence rates exceed men's for these same age ranges by 59 percent and 73 percent, respectively. This finding is perhaps best explained by gender differences in healthcare consumption behavior. Men generally avoid the healthcare system until they need it most, which likely results in higher cost care per episode. Women see their physician more regularly but are also more likely to be hospitalized for asthma, even when symptoms are equivalent to men's. The conclusion? Men may need their employer's push to better self-manage asthma, while women may need self-management aids that give them greater control over symptom severity. Many employers can lower healthcare benefits costs while at the same time helping employees have a better quality of life by engaging a professional with expertise to help employers educate both men and women in the best ways to manage their own disease.