Abstract
Background:
The high cost of asthma care is largely attributed to poor control of disease, in particular the treatment of exacerbations.
Method:
A 1-year, randomised, double blind, double dummy study in adult asthmatics currently receiving >500–1000mcg ICS or 200–500mcg ICS+LABA daily. Both AMD and stable dose regimes were followed in accordance with registered indications. Cost savings from a reduction in exacerbation rates was estimated by applying UK healthcare costs to each of the exacerbation events.
Results:
The ITT population comprised 688 patients (344 in each treatment arm). Thirty-nine (11.3%) patients who received stable dosing SFC experienced an asthma exacerbation compared with 61 (17.7%) patients who received AMD of FBC. Overall there were 48% fewer exacerbations with stable dosing treatment with SFC than AMD with FBC (50 vs. 96 exacerbations respectively). A significant difference between stable dosing treatment with SFC and AMD with FBC in the rate of exacerbations (wks 1–52) requiring oral steroid use or ER/hospital visit, annual adjusted mean rate SFC: 0.18 versus FBC 0.33, p= 0.008. The total annual healthcare costs of managing exacerbations for the SFC group was 荤 3770.73 (荤 5553.36) compared with 荤 6717.25 (荤 9892.86) for the AMD with FBC group. Difference in annual costs of managing exacerbations was 荤 2946.52 (荤 4339.50).
Conclusion:
This analysis showed that stable dose treatment with SFC halves the exacerbation rate and reduces the cost of managing exacerbations by 44% compared with the AMD with FBC group.
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Pieters, W., Williams, A. & Follows, R. Reduced cost of managing exacerbations with stable dose treatment with salmeterol/fluticasone (SFC) compared with adjustable maintenance dosing (AMD) with formoterol/budesonide (FBC). Prim Care Respir J 14, 269 (2005). https://doi.org/10.1016/j.pcrj.2005.06.006
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DOI: https://doi.org/10.1016/j.pcrj.2005.06.006