Advanced

A real-life cost-effectiveness evaluation of budesonide/formoterol maintenance and reliever therapy in asthma

Stallberg, B.; Ekstrom, T.; Neij, F.; Olsson, P.; Skoogh, B. -E.; Wennergren, G. and Löfdahl, Claes-Göran LU (2008) In Respiratory Medicine 102(10). p.1360-1370
Abstract
Objective: To evaluate direct asthma-related costs in Swedish primary care in a real-life setting. Design: 12-month open-label study. Setting: Swedish primary care in a real-life setting. Participants: 1776 patients with persistent asthma. Interventions: Patients with persistent asthma were randomised to one of three treatments: a free adjustable combination of budesonide (100-400 mu g/inhalation) and formoterol (4.5 or 9 mu g/inhalation) via separate inhalers plus terbutaline as needed; budesonide/formoterol (160/4.5 mu g or 80/4.5 mu g, two inhalations twice daily) plus terbutaline as needed; budesonide/formoterol, (160/4.5 mu g or 80/4.5 mu g, one inhalation twice daily or two inhalations once daily), for maintenance plus additional... (More)
Objective: To evaluate direct asthma-related costs in Swedish primary care in a real-life setting. Design: 12-month open-label study. Setting: Swedish primary care in a real-life setting. Participants: 1776 patients with persistent asthma. Interventions: Patients with persistent asthma were randomised to one of three treatments: a free adjustable combination of budesonide (100-400 mu g/inhalation) and formoterol (4.5 or 9 mu g/inhalation) via separate inhalers plus terbutaline as needed; budesonide/formoterol (160/4.5 mu g or 80/4.5 mu g, two inhalations twice daily) plus terbutaline as needed; budesonide/formoterol, (160/4.5 mu g or 80/4.5 mu g, one inhalation twice daily or two inhalations once daily), for maintenance plus additional inhalations as needed. Doses depended on previous inhaled corticosteroid dose. Patients attended the clinic at 0, 1.5, and 12 months. Telephone interviews were conducted at 4, 6, 8, and 10 months. Main outcome measures: The primary endpoint was direct asthma-related healthcare costs. Results: Statistically significant reductions in annual direct costs per patient were observed with budesonide/formoterol maintenance and reliever therapy compared with the free adjustable combination of budesonide and formoterol (-13%, P<0.001) and fixed-dose budesonide/formoterol plus terbutaline (-20%, P<0.001). Time to first severe exacerbation did not differ significantly across treatment groups, with a mean reduction of 28% versus the free adjustable combination of budesonide and formoterol (P=0.076). Patients receiving budesonide/formoterol maintenance and reliever therapy used a significantly lower daily dose of budesonide compared with the conventional (P<0.001). Conclusions: This study reports direct cost savings with budesonide/formoterol maintenance and reliever therapy compared with conventional treatment regimens with at least equivalent efficacy. (C) 2008 Elsevier Ltd. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
budesonide/formoterol maintenance and reliever therapy, budesonide/formoterol, real life, asthma, cost-effectiveness
in
Respiratory Medicine
volume
102
issue
10
pages
1360 - 1370
publisher
Elsevier
external identifiers
  • wos:000259740700002
  • scopus:50549088847
ISSN
1532-3064
DOI
10.1016/j.rmed.2008.06.017
language
English
LU publication?
yes
id
67b743c8-0515-46e2-916b-6439d62b5330 (old id 1286194)
date added to LUP
2009-02-04 09:40:30
date last changed
2017-04-16 03:55:23
@article{67b743c8-0515-46e2-916b-6439d62b5330,
  abstract     = {Objective: To evaluate direct asthma-related costs in Swedish primary care in a real-life setting. Design: 12-month open-label study. Setting: Swedish primary care in a real-life setting. Participants: 1776 patients with persistent asthma. Interventions: Patients with persistent asthma were randomised to one of three treatments: a free adjustable combination of budesonide (100-400 mu g/inhalation) and formoterol (4.5 or 9 mu g/inhalation) via separate inhalers plus terbutaline as needed; budesonide/formoterol (160/4.5 mu g or 80/4.5 mu g, two inhalations twice daily) plus terbutaline as needed; budesonide/formoterol, (160/4.5 mu g or 80/4.5 mu g, one inhalation twice daily or two inhalations once daily), for maintenance plus additional inhalations as needed. Doses depended on previous inhaled corticosteroid dose. Patients attended the clinic at 0, 1.5, and 12 months. Telephone interviews were conducted at 4, 6, 8, and 10 months. Main outcome measures: The primary endpoint was direct asthma-related healthcare costs. Results: Statistically significant reductions in annual direct costs per patient were observed with budesonide/formoterol maintenance and reliever therapy compared with the free adjustable combination of budesonide and formoterol (-13%, P&lt;0.001) and fixed-dose budesonide/formoterol plus terbutaline (-20%, P&lt;0.001). Time to first severe exacerbation did not differ significantly across treatment groups, with a mean reduction of 28% versus the free adjustable combination of budesonide and formoterol (P=0.076). Patients receiving budesonide/formoterol maintenance and reliever therapy used a significantly lower daily dose of budesonide compared with the conventional (P&lt;0.001). Conclusions: This study reports direct cost savings with budesonide/formoterol maintenance and reliever therapy compared with conventional treatment regimens with at least equivalent efficacy. (C) 2008 Elsevier Ltd. All rights reserved.},
  author       = {Stallberg, B. and Ekstrom, T. and Neij, F. and Olsson, P. and Skoogh, B. -E. and Wennergren, G. and Löfdahl, Claes-Göran},
  issn         = {1532-3064},
  keyword      = {budesonide/formoterol maintenance and reliever therapy,budesonide/formoterol,real life,asthma,cost-effectiveness},
  language     = {eng},
  number       = {10},
  pages        = {1360--1370},
  publisher    = {Elsevier},
  series       = {Respiratory Medicine},
  title        = {A real-life cost-effectiveness evaluation of budesonide/formoterol maintenance and reliever therapy in asthma},
  url          = {http://dx.doi.org/10.1016/j.rmed.2008.06.017},
  volume       = {102},
  year         = {2008},
}