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As-Needed Inhaled Corticosteroid-Formoterol in a Single Inhaler Compared to Inhaled Corticosteroid-Albuterol in
Carlos E Rodríguez-Martínez1,2, Monica P Sossa-Briceño3, Jefferson Antonio Buendia4
1Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.
Insights
In Colombian children with mild asthma, a single inhaler of ICS-formoterol is more cost-effective than separate inhalers of ICS-albuterol. This approach offers greater quality-adjusted life-years (QALYs) at a lower overall treatment cost.
Area of Science:
- Health Economics
- Pediatric Pulmonology
- Pharmacoeconomics
Background:
- Current guidelines recommend as-needed low-dose inhaled corticosteroids (ICS) with formoterol in a single inhaler for mild asthma in children over 12.
- ICS-albuterol has been proposed as an alternative where ICS-formoterol is unavailable or unaffordable.
- This study evaluates the cost-utility of these two reliever therapies in Colombia.
Purpose of the Study:
- To compare the cost-utility of as-needed ICS-formoterol in a single inhaler versus ICS-albuterol in separate inhalers for pediatric mild asthma in Colombia.
- To assess treatment costs and health outcomes, specifically quality-adjusted life-years (QALYs).
Main Methods:
- A Markov-type model simulated a cohort of pediatric patients with mild asthma over 12 months.
- Effectiveness data and transition probabilities were sourced from randomized clinical trials (RCTs).
- Cost data were obtained from official Colombian Ministry of Health databases.
Main Results:
- ICS-formoterol in a single inhaler resulted in lower average costs per patient (US$475.51) compared to ICS-albuterol in separate inhalers (US$735.33).
- The single inhaler ICS-formoterol also yielded a greater gain in QALYs (0.9367) versus separate inhalers (0.9352).
- This indicates dominance of the single inhaler ICS-formoterol approach.
Conclusions:
- As-needed ICS-formoterol in a single inhaler is a cost-effective reliever therapy for pediatric patients (≥12 years) with mild asthma in Colombia.
- This strategy provides superior health outcomes (QALYs) at a reduced total treatment cost compared to ICS-albuterol in separate inhalers.
Objectives:
Since 2019 as-needed low-dose ICS-formoterol in a single inhaler has been recommended for treatment of mild asthma in children aged more than 12 years. Alternatively, the use of ICS-albuterol has been proposed in countries where ICS-formoterol is not available or affordable. The aim of the present study was to evaluate the cost-utility of as-needed ICS-albuterol in separate inhalers compared to ICS-formoterol in a single inhaler as reliever therapy in pediatric patients with mild asthma living in Colombia.
Methods:
A Markov-type model was developed to estimate the costs and health outcomes of a simulated cohort of pediatric patients with mild asthma treated for 12 months. The effectiveness data and transition probabilities were obtained from relevant randomized clinical trials (RCTs). Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs).
Results:
The base-case analysis showed that compared with the use of as-needed ICS-albuterol in separate inhalers, the use of ICS-formoterol in a single in pediatric patients with mild asthma was associated with lower costs (US$475.51 vs. 735.33 average cost per patient) and the greatest gain in QALYs (0.9367 vs. 0.9352 QALYs on average per patient), thus leading to dominance.
Conclusions:
Compared with the use of as-needed ICS-albuterol in separate inhalers, the use of ICS-formoterol in a single inhaler as reliever therapy is cost-effective in patients aged 12 years or more with mild asthma, because it showed a greater gain in QALYs at lower total treatment costs.
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