Assessing costs of aerosol therapy

The large economic burden of asthma accentuates the need for economically sound treatment. Numerous studies report that the outcomes produced by nebulizers are equivalent to the outcomes produced by MDI/spacers in selected patients. Studies show that MDI/spacer use will probably result in substantial cost savings to hospitals. Although some patients will not be able to achieve the same outcomes with MDI/spacers as with nebulizers, Bowton et al and Orens et al showed that a large percentage of patients could be converted to the less costly MDI/spacer therapy without negative repercussions. Observation of current treatment practice indicates that hospitals have yet to capitalize on the economic benefits of replacing nebulizers with MDI/spacers. For example, original data from MARC indicate that only 5% of adults who present to an academic ED with acute asthma receive at least one beta agonist treatment via MDI. Studies that improve upon existing cost analyses may convince hospitals of the untapped savings potential. Investigation of barriers to MDI/spacer conversion, along with a compilation of successful strategies for this conversion, would be helpful. Taken together, such research could lead to increased beta agonist delivery via MDI/spacer and probable savings to the health care system.