Cost-Effectiveness Analysis of Salmeterol/Fluticasone Propionate 50/500??g vs Fluticasone Propionate 500??g in Patients with Corticosteroid-Dependent Asthma V: Results

Abstract

Methods: An economic analysis was performed to compare the cost effectiveness of a new formulation combining salmeterol 50μg and fluticasone propionate 500μg in a multidose dry powder (Diskus™) inhaler (n = 167) with that of fluticasone propionate (FP) 500μg (n = 165) also delivered via the Diskus™ in patients with corticosteroid-dependent asthma. Clinical data were obtained from a recent European multicentre trial; the economic analysis adopted a Swedish healthcare perspective. Results: The salmeterol/fluticasone propionate combination (SFC) produced a significantly higher proportion of successfully treated weeks, defined as a ≥5% improvement in percentage predicted peak expiratory flow, than FP alone (57.5 vs 33.6%; p = 0.001). The proportions of symptom-free days (40.2 vs 30.4%; p = 0.012) and episode-free days (30.3 vs 24.9%; p = 0.068) were also higher in the SFC group. Despite the higher drug costs for SFC, the cost per successfully treated week was lower for SFC than for FP alone [SEK365.1 ($US44.30) vs SEK487.8 ($US59.18)]. The incremental cost-effectiveness ratio was SEK192.1 ($US23.31) [95% confidence interval: 58.3, 436.7]. Sensitivity analyses indicated that these results were stable over a range of assumptions. Conclusion: In summary, the new inhaler containing a combination of salmeterol 50μg and FP 500μg led to an increase in healthcare costs but was considerably more effective than FP 500μg alone in patients with corticosteroid-dependent asthma. Despite the additional costs of asthma management, the range of additional benefits suggests that SFC may be a cost-effective treatment option.