The cost-effectiveness of low-dose budesonide as a Step 2 treatment for pediatric asthma in China

Area of Science:

• Pediatric Pulmonology
• Health Economics

Background:

• Asthma management in young children (1-5 years) requires cost-effective treatment strategies.
• Comparing inhaled corticosteroids (ICS) like budesonide with leukotriene receptor antagonists (LTRAs) like montelukast is crucial for optimizing pediatric asthma care.

Purpose of the Study:

• To evaluate the cost-effectiveness of low-dose budesonide compared to montelukast in pediatric patients (1-5 years) in China.
• To provide insights for healthcare payers and clinicians regarding optimal asthma pharmacotherapy for young children.

Main Methods:

• A Markov model was utilized to simulate asthma exacerbations and associated costs over a one-year period.
• Data on exacerbation rates, mortality, quality of life (utilities), and costs were sourced from existing literature.
• The model adopted a Chinese healthcare payer and patient perspective.

Main Results:

• Low-dose budesonide demonstrated a lower rate of exacerbation events (1.44) compared to montelukast (2.15) over one year.
• The total one-year cost was lower with low-dose budesonide (¥3675) versus montelukast (¥4130).
• Low-dose budesonide also yielded slightly higher quality-adjusted life years (0.974) than montelukast (0.967).

Conclusions:

• Low-dose budesonide is economically and clinically superior to montelukast for managing asthma in pediatric patients aged 1-5 years.
• These findings support the increased utilization of low-dose budesonide as a preferred asthma therapy in this age group.
• The study provides valuable economic evidence for formulary decisions and treatment guidelines in pediatric asthma care.