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A real-life cost-effectiveness evaluation of budesonide/formoterol maintenance and reliever therapy in asthma
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centrum för klinisk forskning i D län (CKFD).
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2008 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 102, no 10, 1360-1370 p.Article in journal (Refereed) Published
Abstract [en]

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 microg/inhalation) and formoterol (4.5 or 9 microg/inhalation) via separate inhalers plus terbutaline as needed; budesonide/formoterol (160/4.5 microg or 80/4.5 microg, two inhalations twice daily) plus terbutaline as needed; budesonide/formoterol (160/4.5 microg or 80/4.5 microg, 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.

Place, publisher, year, edition, pages
2008. Vol. 102, no 10, 1360-1370 p.
Keyword [en]
Asthma, cost-effectiveness, real-life, budesonide/formoterol, budesonide/formoterol maintenance and reliever therapy
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-104949DOI: 10.1016/j.rmed.2008.06.017ISI: 000259740700002PubMedID: 18723335OAI: oai:DiVA.org:uu-104949DiVA: diva2:220301
Available from: 2009-05-31 Created: 2009-05-31 Last updated: 2017-12-13Bibliographically approved

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Ställberg, Björn

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