Economic analysis of asthma practices

When deciding on treatment for patients with asthma, clinicians should consider the following: basic science that supports the therapeutic agent, randomized clinical trials that demonstrate clinical efficacy, and "real world" economic evidence that confirms the basic science and clinical study findings. When selecting first-line controller therapy for persistent asthma, clinicians should look for the single agent that produces the greatest improvement in lung function and patient outcomes, has minimal adverse effects, and is cost effective. To determine whether there is one first-line controller that achieves all of these goals, physicians should evaluate findings of randomized controlled trials that assess a drug's effect on asthma symptoms, lung function, and albuterol use compared with placebo or a comparator. They should also consider findings from retrospective claims analyses. This combination of data provides a truer picture and more robust evidence of a drug's clinical and economic performance. Similar evaluations need to be undertaken when deciding on the most cost-effective add-on therapy.