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A cost-effectiveness analysis of first-line controller therapies for persistent asthma
Ya-Chen Tina Shih1, Josephine Mauskopf, Rohit Borker
1Section of Health Services Research, Department of Biostatistics, Division of Quantitative Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Pharmacoeconomics
|July 6, 2007
Summary
Single-inhaler salmeterol/fluticasone propionate offers a cost-effective asthma management strategy. This treatment provides incremental effectiveness at a lower cost than commonly accepted benchmarks, making it a valuable option for patients with mild-to-moderate persistent asthma.
Area of Science:
- Pharmacoeconomics
- Health Outcomes Research
- Respiratory Medicine
Background:
- Asthma prevalence is increasing in the US, leading to significant management challenges and costs for managed care organizations (MCOs).
- Many patients do not achieve therapeutic goals despite available controller medications, highlighting the need for cost-effective treatment strategies.
- MCOs are motivated to evaluate both clinical and economic value of asthma therapies due to high treatment costs.
Purpose of the Study:
- To conduct a cost-effectiveness analysis of first-line controller asthma therapies.
- To compare single-inhaler salmeterol/fluticasone propionate against other first-line treatments from an MCO payer perspective.
- To evaluate therapies for patients with mild-to-moderate persistent asthma.
Main Methods:
- A decision-analysis model was developed to assess cost-effectiveness over a 1-year period.
- Compared single-inhaler salmeterol/fluticasone propionate with fluticasone propionate inhaled corticosteroids (FPIC), non-fluticasone propionate inhaled corticosteroids (nFPIC), and leukotriene modifiers.
- Utilized data from clinical trials and observational studies, with expert evaluation of adherence-effectiveness assumptions. Effectiveness measured by symptom-free and rescue medication-free days.
Main Results:
- Single-inhaler salmeterol/fluticasone propionate demonstrated a cost-effectiveness of $US9.55 per symptom-free day and $US8.93 per rescue medication-free day compared to FPIC.
- Probabilistic sensitivity analysis indicated a 98% probability of single-inhaler salmeterol/fluticasone propionate being more cost-effective than FPIC at a benchmark of $US14.8 per symptom-free day.
- nFPIC and leukotriene modifiers showed lower probabilities (30.7% and 2.1%, respectively) of being more cost-effective than FPIC.
Conclusions:
- Single-inhaler salmeterol/fluticasone propionate treatment appears to be a cost-effective option compared to FPIC and nFPIC.
- The incremental costs for effectiveness gains with single-inhaler salmeterol/fluticasone propionate are below commonly accepted cost-effectiveness benchmarks.
- This therapy may also present a more favorable cost-effectiveness profile than leukotriene modifiers for managing mild-to-moderate persistent asthma.
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