Advances in Therapy

, Volume 30, Issue 10, pp 933–944 | Cite as

Budget Impact Analysis of a Fixed-Dose Combination of Fluticasone Propionate and Formoterol Fumarate (FP/FORM) in a Pressurized Metered-Dose Inhaler (pMDI) for Asthma

  • William DunlopEmail author
  • Louise Heron
  • Georgia Fox
  • Maire Greaney
Original Research



The economic burden of asthma on the UK National Health Service (NHS) is the largest among allergic diseases. Current asthma guidelines recommend adding a long acting β2-agonist (LABA) to a low-dose inhaled corticosteroid (ICS) in patients who are on ICS monotherapy and have uncontrolled asthma. The fixed-dose combination of fluticasone propionate and salmeterol xinafoate (FP/SAL), available in a pressurized metered-dose inhaler (pMDI) device, is the most commonly prescribed ICS/LABA combination. An additional fixed-dose combination of fluticasone propionate and formoterol fumarate (FP/FORM) in pMDI is now available. In a 12-week non-inferiority study, FP/FORM demonstrated comparable efficacy to FP/SAL. The present analysis estimates the annual budget impact for the UK NHS using FP/FORM as an alternative to FP/SAL.


Current pMDI prescribing data were from a real-world UK patient database (Cegedim Strategic Data). Annual costs to the NHS for drug acquisition, administration, and monitoring were estimated for FP/FORM and FP/SAL and used to assess the potential budget impact for the NHS for the use of FP/FORM instead of FP/SAL. Varying rates of uptake, adherence, adverse event-related costs, and resource use associated with switching treatment were assessed in scenario analyses.


Assuming similar levels of ICS use with both regimens, annual drug acquisition costs per person were lower with FP/FORM (£412) than with FP/SAL (£509). The difference in acquisition costs and otherwise comparable input costs between the treatments, results in potential annual savings of £15,110,279 to the NHS, assuming uptake of FP/FORM over FP/SAL in 50% of existing patients. The introduction of FP/FORM results in cost savings for the NHS in all of the assessed scenario analyses.


The comparable efficacy and lower acquisition costs of FP/FORM compared with FP/SAL make it a cost-saving option for the UK NHS for the treatment of asthma patients requiring combination maintenance therapy using a pMDI.


Asthma Budget Cost savings Fluticasone propionate Formoterol fumarate Pressurized metered-dose inhaler Respiratory 



Sponsorship and article processing charges for this study were funded by Mundipharma International Ltd, United Kingdom. Adelphi Values Ltd received funding from Mundipharma International Ltd to support this research. Mr. Dunlop is the guarantor for this article, and takes responsibility for the integrity of the work as a whole.

Conflict of interest

William Dunlop is an employee of Mundipharma International Ltd, United Kingdom. Louise Heron is an employee of Adelphi Values Ltd, UK. Georgia Fox is an employee of Adelphi Values Ltd, UK. Maire Greaney is an employee of Adelphi Values Ltd, UK. The authors do not report any conflict of interest with regards to the contents of this study other than those stated.

Compliance with ethics

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Healthcare 2013

Authors and Affiliations

  • William Dunlop
    • 1
    Email author
  • Louise Heron
    • 2
  • Georgia Fox
    • 2
  • Maire Greaney
    • 2
  1. 1.Mundipharma International LimitedCambridgeUK
  2. 2.Adelphi ValuesBollingtonUK

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