Authors: Stanford R.H.¹; Edwards L.D.²; Rickard K.A.²

Source: Clinical Drug Investigation, Volume 20, Number 4, 1 October 2000 , pp. 237-244(8)

Publisher: Adis International

Abstract:

Objective: To compare the cost effectiveness of fluticasone propionate (FP) and triamcinolone acetonide (TA) in patients with persistent asthma.

Design: Resource utilisation and clinical data were obtained prospectively from two multicentre, randomised, parallel-group, double-blind, double-dummy, placebo-controlled studies conducted in the USA. Costs are presented from the perspective of third party payers.

Patients and Participants: 397 corticosteroid-dependent patients with persistent asthma.

Methods: Patients were treated with FP 250µg twice daily or TA 200µg four times daily for 24 weeks. All patients were given salbutamol (albuterol) to be used as rescue medication. Data were examined using intent-to-treat analysis.

Results: A significantly greater number of patients treated with FP had a 12% increase in forced expiratory volume in 1 second (FEV) [53% versus 32%, p < 0.001] from baseline compared with patients treated with TA. Also, the mean daily cost per successfully treated patient (12% increase in FEV) was lower in FP-treated patients than in TA-treated patients ($US4.76 vs $US7.43, 1999 values), with an incremental cost-effectiveness ratio of $US0.68 per day per additional patient reaching a 12% improvement in FEV.

Conclusion: From a payer perspective, FP 250µg twice daily administered by Diskhaler is more cost effective than TA 200µg four times daily administered by metered-dose inhaler in patients with persistent asthma over 24 weeks.

Keywords: Asthma, treatment; Cost effectiveness; Fluticasone propionate, therapeutic use; Pharmacoeconomics; Triamcinolone, therapeutic use

Document Type: Original article

Affiliations: 1: US Medical Affairs Health Outcomes, Glaxo Wellcome, Inc., Research Triangle Park, North Carolina, USA 2: US Medical Affairs, Glaxo Wellcome, Inc., Research Triangle Park, North Carolina, USA

Publication date: 2000-10-01

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