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Salmeterol

An Appraisal of its Quality-of-Life Benefits and Potential Pharmacoeconomic Positioning in Asthma

  • Pharmacoeconomic Drug Evaluation
  • Published:
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Summary

Synopsis

Salmeterol is a selective β2-receptor agonisl with long duration of action that permits twice daily administration. It is effective in the prophylaxis of asthma symptoms, including nocturnal and exercise-induced asthma, and it has shown clinical benefits in both adults and children. Because of its slow onset of action, salmeterol is not intended for relief of acute symptoms.

The addition of salmeterol 50μg twice daily to existing asthma therapy has a positive effect on patient quality of life in the short term (up to 3 months), as assessed by the Living With Asthma Questionnaire and Asthma Quality of Life Questionnaire. This improvement in well-being appears to be greater than that associated with salbutamol (albuterol). Furthermore, in patients with asthma symptoms despite inhaled corticosteroid therapy, a reduced dose of corticosteroid plus salmeterol produced a greater improvement in quality of life as assessed by a daily symptom lliaty (hut lint by the Living With Asthma Questionnaire), and was more clinically effective than a higher dose of corticosteroid alone. Evaluation of the effects of salmeterol on quality of life compared witll other standard therapies, and extension of these results into the long term are required to consolidale these conclusions.

Salmeterol 50μg twice daily was associated with an estimated incremental cost of £736 per symptom-free patient in the final week of 7.5 months’ therapy.£648 per patient with improve morning (am) peak expiratoty flow rate (PEFR)and £1013 per patient with improved evenig (pm) PEFR compared with .flIlblllamol (400μg twice daily) in a cost-effectiveness analysis. However, these results should be tested by sensitivity analyses and compared with the incremental costs of other asthma interventions more applicable to recommended clinical practice.

The cost effectiveness of salmeterol relative to other asthma therapies, and the effect of salmeterol of patient quality of life in the long term require further investigation. However, when added to existing asthma therapy, salmeterol improves patient quality of life in the short term (up to 3 months). It may also have some beneficial effects on patient well-being when used to provide a steroid-sparing effect.

General Considerations

Recent studies suggest the prevalence of asthma, as well as hospital isation and mortality rates, may now have stabilised in some countries following an increase over the last several decades.

Economic assessments of intervention strategies for asthma are few. Drug acquisition costs and costs of hospitalisation appear to be the greatest contributors to direct costs of asthma, but indirect costs also contribute significantly to the total costs associated with the disease. Intangible costs are probably the greatest component of total asthma costs. but they are difficult to quantify in a monetary sense. However, they may be assessed in terms of effects on patient quality of life.

There are several specific instruments available to assess quality of life in patients with asthma, with considerable evidence to support their content validity. General instruments assessing quality of life are probably insensitive to clinical change in patients with mild asthma. although a combination of generic and specific instruments may be useful to assess new thempeutic regimens.

Pharmacoeconomic Assessment of Salmeterol

Salmeterol 50μg twice daily added to existing asthma therapy improved quality of life relative to placebo or salbutamol (albuterol) in 5 short term studies (up to 3 months). The positive effects of salmeterol compared with other treatments were observed for global assessments and for individual domains of 2 validated instruments (Living With Asthma Questionnaire and Asthma Quality of Life Questionnaire) for measuring quality of life in asthma. A further short term study evaluated patients with asthma symptoms despite inhaled corticosteroid therapy. A reduced dose of corticosteroid plus salmeterol produced a greater improvement in quality of life as assessed by a daily symptom diary (but not by the Living With Asthma Questionnaire) than a higher dose of corticosteroid alone.

Two briefly reported st udies have assessed the cost effectiveness of salmeterol using direct costs only. The estimated incremental cost of salmeterol 50μg twice daily compared with salbutamol 400μg twice daily was £736 per symptom-free patient in the final week of 7.5 months’ therapy, £648 per patient with improved morning (am) peak expiratory flow rate (PEFR) and £1013 per patient with improved evening (pm) PEFR. These conclusions should be tested by sensitivity analyses and compared with the incremental costs of salmelerol versus other asthma inlerventions more applicable to recommended clinical practice. Salmeterol was also considered to be morc cost effective than salbutamol when priced up to $Can2.06 per day in a Canadian analysis using clinically relevant regimens.

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References

  1. Brogden RN, Faulds D. Salmeterol xinafoate: a review of its pharmacological properties and therapeutic potential in reversible obtructive airways desease. Drugs 1991 Nov; 42: 895–912

    Article  PubMed  CAS  Google Scholar 

  2. Britton MG, Earnshaw J, Palmer JBD. et al. A twelve month comparison of salmeterol with salbutamol in asthmatic patients. Eur Respir J 1992 Oct; 5: 1062–7

    PubMed  CAS  Google Scholar 

  3. Castle W, Fuller R, Hall J, et al. Serevent nationwide surveillance study: comparison of salmeterol with salbutamol in asthmatic, patients who require regular bronchodilator treatment. BMJ 1993 Apr 17; 306: 1034–7

    Article  PubMed  CAS  Google Scholar 

  4. Cheung D, Timmers MC, Zwinderman A, et al. Long–term effects of a long–acting B2–adrenoceptor agonist salmetrol on airway hyperresponsiveness in patients with mild asthma. N Engl J Med 1992 22; 327: 1198–203

    Article  PubMed  CAS  Google Scholar 

  5. Douglas NJ, Fitzpatrick MF. Effects of salmeterol on nocturnal asthma. Eur Resp Rev 1991 Nov; 1: 293–6

    Google Scholar 

  6. Greening AP, Ind PW, Northfield M, et al. Added salmeterol versus higher–dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Lancet 1994 Jul 23; 344: 219–24

    Article  PubMed  CAS  Google Scholar 

  7. Gustafsson PM, Von BA, Jenkins MM. Salmeterol 50 micrograms twice daily in the treatment of mild–to–moderate asthma in childhood–a comparison of two inhalation devices. Eur J Clin Res 1994; 5: 63–73

    Google Scholar 

  8. Johnson ME, UK Study Group. A multicentre study to compare the efficacy and safety of salmeterol xinafoate and nedocromil sodium via metered–dose inhalers in adults–mild–moderate asthma. Eur J Clin Rn 1994; 5: 75–85

    Google Scholar 

  9. JoneS KP, UK Study Group. Salmeterol xinafoate in the treatment of mild to moderate asthma in primary care. Thorax 1994 Oct; 49: 971–5

    Article  PubMed  CAS  Google Scholar 

  10. LUndback B, Rawlinson DW, Palmer JBD. Twelve month comparison of salmeterol and salbutamol as dry powder formulations in asthmatic paitients. Thorax 1993 Feb; 48: 148–53

    Article  PubMed  CAS  Google Scholar 

  11. Makino S. Clinical study of salmeterol xinafoate (SN408) dry powder–examination in patients with bronchial asthma [inJapanese]. In: Rinsho Iyaku:, 1993: 2443–58

    Google Scholar 

  12. Mikawa H, Mayumi M, Kimata H,et al. Clinical study of salmeterol xinafoate (SN408) aerosol–comparative study by multiple administration in children with bronchial aSthma [in Japanese]. Rinsho Iyaku 1993; 9 Suppl. 4: 179–99

    Google Scholar 

  13. Miyamoto T, Takishima T, Makino S, et al. Clinical study of salmeterol xinafoate (SN408) aersol: double–blind parallel study between procaterol tablet in patients with bronchial asthma [in Japanese]. Rinsho Iyaku 1993: 9 (11): 2671–99

    Google Scholar 

  14. Miyamoto T, Makino S, Kabe J, et al. Clinical study of salmeterol xinafoate (SN 408) aerosol–comparative study by multiple administration in patients with bronchial asthma [inJapanese]. Rinsho Iyaku 1993; 9 suppl. 4: 49–79

    Google Scholar 

  15. Muir JF, Bertin L, Georges D. Salmeterol versus slow–realease theophylline combined with ketotifen in nocturnal asthma: a multicentre trial. Eur Respir J 1992 Nov; 5: 1197–200

    PubMed  CAS  Google Scholar 

  16. Palmer JBD, Stuart AM, Shepered GL. Inhaled salmeterol in the treatment of patientS with moderate to severe reversible obtructive airways disease–a 3 month comparison of the efficacy and safety of twice–daily salmeterol (100ug) with salmeterol (50ug). Respir Med 1992 Sep; 86: 409–17

    Article  PubMed  CAS  Google Scholar 

  17. Pearlman DS, Chervinsky P, Laforce C, et al. A comparison of salmeterol with albuterol in the treatment of mild–to–moderate asthma. N Engl J Med 1992 Nov 12; 327: 1420–5

    Article  PubMed  CAS  Google Scholar 

  18. Sichletidis L, Daskalopoulou E, Kyrias G. et al. Comparative efficacy of salbutamol and salmeterol in exercise–induced asthma. J Int Met Res 1993 Mar–Apr; 21: 81–8

    CAS  Google Scholar 

  19. Yukawa T, Makino S, Miyamoto T, el al. Clinical study of salmeterol xinafoate (SN408) aerosol–long–term study in patients with bronchial asthma [in Japanese]. Rinsho Iyaku 1993; 9 Suppl. 4: 113–31

    Google Scholar 

  20. Venables T. A multicenlre study in general practice!o compare the efficacy and tolerability of inhaled salmeterol xinafoate and terbuline in the treatment of asthma. Br J Clin Res 1992; 3: 12S–36

    Google Scholar 

  21. Weiss KB, Sullivan SD. The economic costS of asthma. A review and conceptual model. Pharmaeconomics 1993 Jul; 4: 14–30

    Article  CAS  Google Scholar 

  22. Mellis CM, Peat JK, Woolcock AJ. The cost of asthma: can it be reduced? Pharmacoeconomics 1993 Mar; 3: 205–19

    Article  PubMed  CAS  Google Scholar 

  23. Anderson HR. Epidemiolgy of asthma. Br J Hosp Med 1992 Jan 23; 47: 99–104

    PubMed  CAS  Google Scholar 

  24. Woolcock AJ. The problem of asthma worldwide. Eur Resp Rev 1991 Nov;: 243–6

  25. Lebowitz MD, Spinaci S. The epidemiology of asthma. Eur Resp Rev 1993 Jun; 5 (Rev.14): 415–23

    Google Scholar 

  26. Littlejohns P. Macdonald L.D. The relationship betweeen severe asthma and social class. Respir Med 1993 Feb; 87: 139–43

    Article  PubMed  CAS  Google Scholar 

  27. Lenney W, Wells NEJ. O’Neill BA. The burden pediatric asthma. Eur Rep Rev 1994 Jan: 4: 49–62

    Google Scholar 

  28. Popp W, Wagner C, Merkle M. el al. Allergic rhi nit is, airwa~ compla ints. and bronchial asthma in the population orVienna[in Germani. Wien Klin Wochenschr 1993; 105 (13): 377–81

    PubMed  CAS  Google Scholar 

  29. Siracusa A, Marcucci F, Sensi L, et al. Epidemiology of asthma and rhinitis in an area of central Italy; preliminary data. Eur Resp Rev 1993 Jun; 3 (Rev. 14): 410–2

    Google Scholar 

  30. Barry DM, Burr ML, Limb ES. Prevalence of asthma among 12 year old children in New Zealand and South Wales: a comparative survey. Thorax 1991 Jun; 46: 405–9

    Article  PubMed  CAS  Google Scholar 

  31. Peace N, Weiland S, Keil U, et al. Self–reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol. Eur Respir J 1993 Nov; 6: 1455–61

    Google Scholar 

  32. Robertson CF, Bishop J, Sennhauser FH, et al. International comparison of asthma prevalence in children of Australia,Switzerland, Chile. Pediatr Pulmonol 1993 Oct; 16: 219–26

    Article  PubMed  CAS  Google Scholar 

  33. Peat JK, Gray EJ, Mellis CM. et al. Differernces in airway responsiveness between children and adults living in the same environment an epidemiological study in two regions of New South Wales. Eur Respir J 1994 Oct; 7: 1805–13

    Article  PubMed  CAS  Google Scholar 

  34. Burr ML, Epidemiology of asthma. Monographs in Allergy 1993; 31: 80–102

    PubMed  CAS  Google Scholar 

  35. Anderson HR, Butland BK, Strachan DP. Trends in prevalence and severity of childhood asthma. BMJ 1994 Jun 18; 308: 160–4

    Google Scholar 

  36. Ayres JG, Noah ND, Fleming DM. Incidence of episodes of acute asthma and acute bronchitis in general practice 1976–87. Br J Gen Pratt 1993 Sep; 43: 361–4

    CAS  Google Scholar 

  37. Carlsen K-H Epidemiology of childhood asthma. Eur Resp Rev 1994 Jan; 4: 5–9

    Google Scholar 

  38. Quinliliani R. The epidemiology of mild, moderate, and severe asthma. Adv Ther 1994 Mar–Apr; 11: 70–7

    Google Scholar 

  39. Burr ML, Butland BK, King S, et al. Changes in asthma prevalence:two surveys 15 years apart. Arch Dis Child 1989 Oct; 64: 1452–6

    Article  PubMed  CAS  Google Scholar 

  40. Peat JK, Haby M, Spijker J, et al. Prevalence of asthma in adults in Busselton Western Australia. BMJ 1992; 305: 1326–9

    Article  PubMed  CAS  Google Scholar 

  41. Peat JK, van den Berg RH, Green WF, et al. Changing prevalence of asthma in Australian children. BMJ 1994 Jun 18; 308: 1591–6

    Article  PubMed  CAS  Google Scholar 

  42. Sly RM. Changing asthma mortality. Ann Allergy 1994 Sep; 73: 259–68

    PubMed  CAS  Google Scholar 

  43. Hyndman SJ, Williams DRR, Merrill SL, et al. Rates of admission to hospital for asthma. BMJ 1994 Jun 18; 308: 1596–600

    Article  PubMed  CAS  Google Scholar 

  44. Vollmer WM, Buist AS, Osborne ML. Twenty year trends in hospital discharges for asthma among members of a health maintenance organizalion. J Clin Epidemiol 1992 Sep; 45: 999–1006

    Article  PubMed  CAS  Google Scholar 

  45. Pearce N, Beasley R, Crane J, et al. End of the New Zealand asthma mortality epidemic. Lancet 1995; 345: 41–4

    Article  PubMed  CAS  Google Scholar 

  46. Fleming DM, Crombie DL, Prevalence of asthma and hay fever in England and Wales. BMJ 1987; 294: 279–83

    Article  PubMed  CAS  Google Scholar 

  47. Yunginger JW, Reed CE, O’Connell EJ. et al. A community–based study of the epidemiology of asthma. Incidence rates,1964–1983. Am Rev Respir Dis 1992 Oct; 146: 888–94

    PubMed  CAS  Google Scholar 

  48. Jenkins MA, Hurley SF, Bowes G, et al. Use of antiasthmatic drugs in Australia. Med J Aust 1990; 153: 323–8

    PubMed  CAS  Google Scholar 

  49. Kesten S, Rebuck AS, Chapman KR. Trends in asthma and chronic obstructive pulmonary disease therapy in Canada, 1985 to 1990. J Allergy Clin Immunol 1993 Oct; 92: 499–506

    Article  PubMed  CAS  Google Scholar 

  50. Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med 1992 Mar 26; 326: 862–6

    Article  PubMed  CAS  Google Scholar 

  51. Mellis CM, Peat JK, Bauman AE. The cost of asthma in New South Wales. Med J Aug, 1991 Oct 21; 155: 522–8

    CAS  Google Scholar 

  52. Clark NM, Feldman CH, Evans D, et al. The impact of health education on frequency and cost of health care use by low income children with asthma. J Allergy Clin Immanol 1986 Jul: 78 (1 Pt 1): 108–15

    Article  CAS  Google Scholar 

  53. Lewis CE, Rachelefsky G, Lewis MA et al. A randomized trial of ACT(asthma care training) for kids. Pediatrics 1984 Oct; 74: 478–86

    PubMed  CAS  Google Scholar 

  54. Muhlhauser I, Richter B, Kraut D, et al. Evaluation of a structured treatment and teaching programme on asthma. J Intern Med 1991; 230: 157

    Article  PubMed  CAS  Google Scholar 

  55. Self TH, Ellis RF, Davis HL, et al. Early use of theophylline in hospitalised chronic obstructive pulmonary disease patients:cost–containment through medical education. Drug Intell Clin Pharm 1985; 19: 749–53

    PubMed  CAS  Google Scholar 

  56. Windsor RA, Bailey W, Richards JM, et al. Evaluation of the efficacy and cost–effectiveness of health education methods to increase medication adherence among adults with asthma. Am J Public Health 1990; 80: 1519–21

    Article  PubMed  CAS  Google Scholar 

  57. Sondergaard B, Davidsen F, Kirkeby B, et al. The econo mics of an intensive education programme for asthmatic patients. A prospective controlled trial. Pharmacoeconomics 1992; 1: 207–12

    Article  Google Scholar 

  58. Tougaard L, Krone T, Sorknaes A, et al. Economic benefits of teaching patients with chronic obstructive pulmonary disease about their illness, Lancet 1992; 339: 1517–20

    Article  PubMed  CAS  Google Scholar 

  59. Trautner C, Richter B, Berger M. Cost–effectiveness of a structured treatment and teaching programme on asthma. Eur Res–pir J 1993 Nov; 6: 1485–91

    CAS  Google Scholar 

  60. Davis R, McTavish D. Budesonide: an appraisal of the basis of its pharmacoeconomic and quality–of–life benefits in asthma. Pharmacoeconomics, In Press

  61. Emerman CL, Cydulka RK, Effron D, et al. A randomised controlled comparison of isoetharine and albuterol in the trealment of acute asthma. Ann Emerg Med 1991; 20: 1090–3

    Article  PubMed  CAS  Google Scholar 

  62. Jasper AC, Mohsenifar Z, Kahan S, et al. Cost–benefit comparison of aerosol bronchodilator delivery methods in hospitalised patients. Chest 1987; 91: 614–8

    Article  PubMed  CAS  Google Scholar 

  63. Littenberg B, Gluck EH. A controlled trial of methylprednisolone in the emergerncy room treatment of acute asthma. N Engl J Med 1986; 314: 150–2

    Article  PubMed  CAS  Google Scholar 

  64. Ross RN, Morris M, Sakowitz SR, et al. Cost–effectiveness of icluding cromolyn sodium in the treatment program for asthma: a retrospective, recor–based study. Clin Ther 1988; 10: 188–203

    PubMed  CAS  Google Scholar 

  65. Rutten-Van Molken MPMH, Van Doorslaer EKA, Jansen MCC, et al. Cost effectiveness of inhaled corticosteroid plus bronchodilator monotherapy in children with asthma. Pharmacoeconomics 1993; 4: 257–70

  66. Summer W, Elston R, Tharpe L, et al. Aerosol broncholdilator delivery methods: relalitive impact on pulmonary function and cost of respiratory care. Arch Intern Med 1989; 149: 618–23

    Article  PubMed  CAS  Google Scholar 

  67. Tierce JC, Meller W, Berlow B,et al. Assessing the cost of albuterol inhalers in the Michigan and California Medic aid programs:a total cost–of–eare approach. Clin Ther 1989; 11: 53–61

    PubMed  CAS  Google Scholar 

  68. Bryan S, Buxton MJ. Economic evaluation of treatmentS for respiratory disease. Pharmacoeconomics 1992 Sep; 2: 207–18

    Article  PubMed  CAS  Google Scholar 

  69. Jones PW. Measurement of health in asthma and chronic obstructive airways disease. Pharm Med 1992 Mar; 6: 13–22

    Google Scholar 

  70. Hyland ME. The Living with Asthma Questionnaire. Respir Med 1991 Sep; 85 Suppl. B: 1–6

    Google Scholar 

  71. Juniper JF, Guyan GH, Epstein RS. et al Evaluation of impairment of health related qual ity of life in asthma: development of a questionnaire for use in clinical trials. Thorax 1992 Feb: 47: 76–83

    Article  PubMed  CAS  Google Scholar 

  72. Guyatt GH, Berman LB, Townsend M, et al. A measure of quality of life for clinical trials in chronic lung disease. Thorax 1987; 42: 77–83

    Article  Google Scholar 

  73. Guyan GH, Townsend M, Berman LB, et al. Quality of life in patients with chronic airflow limitation. Br J Dis Chest 1987; 81: 45–54

    Article  Google Scholar 

  74. Jones PW, Quirk FH, Baveystock CM. The St. George’s Respiratory Questionnaire. Respir Med 1991 Sep; 85 Suppl. B: 25–31

    Article  Google Scholar 

  75. Creer TL, Wigal JK, Kosles H, et al. A life activities questionnaire for adult. J Asthma 1992; 29: 393–9

    Article  PubMed  CAS  Google Scholar 

  76. Marks GB, Dunn SM, Woolcock AJ. A scale for measurement of quality of life in adult with asthma. J Clin Epidemiol 1992; 45: 461–72

    Article  PubMed  CAS  Google Scholar 

  77. Pharmacoeconomic and QOL analysis gives new insights into respiratory disease. Drug Ther Perspect 1993 May 10; 1 (8): 15–6

  78. Hyland ME. Quality of life assessment in respiratory disease. An examination of the content and validity of four questionnaires. Pharmacoeconomics 1992; 2: 43–53

    Article  PubMed  CAS  Google Scholar 

  79. Hyland ME, Kenyon CAP, Jacobs PA. Evidence for problem and evaluation constructs of the Living with Asthma Questionnaire; a multinational psychometric comparison [abstract]. Qual Life Res 1994 Feb; 3: 80

    Google Scholar 

  80. Jones PW, Quirk FH, Baveystock CM, et al. A self–complete measure of health status for chronic airflow limitation. The St.George’s Respiratory Questionnaire. Am Rev Res pir Dis 1992 Jun; 145: 1321–7

    CAS  Google Scholar 

  81. Juniper EF, Guyatt G, Ferrie PJ, et al. Measuring qualilY of life in asthma. Am Rev Respir Dis 1993 Apr: 147: 832–8

    PubMed  CAS  Google Scholar 

  82. Juniper EF, Guyatt GH, Willan A, et al. Determining a minimal important change in a disease–specific quality of life questionnaire. J Clin Epidemiol 1994; 47: 481–7

    Article  Google Scholar 

  83. Palmer JBD, Hyland ME. Salmeterol in clinical practice: comparator and safety studies, quality of life studies. Eur Res Rev 1991 Nov; 1: 301–3

    Google Scholar 

  84. Rowe BH, Oxman AD. Performance of an asthma quality of life questionnaire in an outpatient setting. Am Rev Respir Dis 1993 Sep; 148: 675–81

    Article  PubMed  CAS  Google Scholar 

  85. Rowe BH, Oxman AD. An assessment of the sensibilitY of a quality–of–life instrument. Am J Emerg Med 1993 Jul; II: 374–80

    Article  Google Scholar 

  86. Williams VC. Design and validation of qualily of life instruments: a case study for asthma [abstract]. Drug Info J 1993 Jul–Sep; 27: 849–50

    Article  Google Scholar 

  87. Santanello NC. Including a generic quality of life measure with a disease–specific measure in an asthma clinical trial: advantages and disadvantages [abstract]. Drug Info J 1993 Jul–Sep; 27: 870–1

    Google Scholar 

  88. Charpin D, Vervleot D, Bons J, et al. QualitY of life in moderate chronic asthma: salmeterol versus current treatments [abstract]. Am Rev Res–pir J 1992 Aug: 5 Suppl. 15: 12s

    Google Scholar 

  89. Hyland ME, Crocker GR. Validation of an asthma quality of life diary in a clinical trial. Thorax. In press

  90. Hyland ME, Kenyon CAP, Jacobs PA. Sensitivity of quality of life domains and constructs to longitudinal change in a clinical trial comparing salmeterol with placebo in asthmatics. Qual Life Res 1994 Apr; 3: 121–6

    Article  PubMed  CAS  Google Scholar 

  91. Juniper EF, Johnston PR, Borkhoff CM, et al. Quality of life in asthma clinical trials: comparison of salmeterol and salbutamol. Am J Respir Crit Care Med 1995; 151: 66–70

    PubMed  CAS  Google Scholar 

  92. Rutten-van Molken MPMH, Custers F, Van Doorslaer EKA, et al. Comparing lhe performance of four different instruments in evaluating the effectS of salmeterol on asthma quality of life. Eur Respir J 1995: In press

  93. Hall JR, Miocevich ML, O’Neill B,. et al. A comparison of the cost effectiveness of salmeterol v salbutamol in patients with moderate asthma [abstract]. Thorax 1992 Oct; 47: 883

    Google Scholar 

  94. Rutten-Van Molken MPMH, van Doorslaer EKA, Jansen MCC, et al. Costs and effects of inhaled corticosteroids and bronchodilators in asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1995; 151: 975–82

  95. Chin W, Berka C. Salmeterol: a cost–effective asthma medication in Canada [abstract]. J Allergy Clin Immunol 1994 Jan; 93 (Pt.2): 249

  96. Warner JO, Niejens HJ, Landau LI, et al. Asthma: a follow up statement of an international paediatric asthma consensus group. Arch Dis Child 1992; 67: 240–8

    Article  Google Scholar 

  97. Warner JO, Gotz M, Landau LI, et al. Management of asthma: a consensus statement. Arch Dis Child 1989;: 1065–79

  98. British Thoracic Society. Guidelines on the management of asthma. Thorax 1993; 48 Suppl.; 51–524

    Google Scholar 

  99. Hargreave F, Dolovich J, Newhouse MT. The assessment and treatment of asthma: a conference report. J Allergy Clin Imunol 1990; 85: 1098–11

    Article  CAS  Google Scholar 

  100. National Heart Lung and Blood Institute National Asthma Education Program Expert Panel Report. Guidelines for the diagnosis and management of asthma. J Allergy Clin Immunol; 88: 425–534

  101. McFadden Jr ER, Gilbert IA. Asthma. N Engl J Med 1992; 327: 1928–37

  102. Sears MR, Taylor DR, Print CG, et al. Regular inhaled betagonist treatment in bronchial asthma. Lancet 1990; 336: 1391–6

    Article  PubMed  CAS  Google Scholar 

  103. Devoy MAB, Fuller RW, Palmer JBD. Are there any detrimental effects of the use of inhaled long–acting b2–agonists in the treament of asthma? Chest 1995; 107: 1116–24

    Article  PubMed  CAS  Google Scholar 

  104. D’Angio R. Focus on salmeterol. A long acting inhaled B2–adrenergic receptor agonist for the treatment of asthma. Hosp Formul 1993 Sep: 28: 141–53

    Google Scholar 

  105. Finkelstein FN, Risks of salmeterol [letterer]. N Engl J Med 1994 Nov 10; 331: 1314

    Article  PubMed  CAS  Google Scholar 

  106. Lotvall J, Lude H, Ullman L, et al. Twelve months treatment with inhaled salmeterol in asthmatic patients: effects on the receptor function and inflammatory cells. Allergy 1992; 47: 477–83

    Article  PubMed  CAS  Google Scholar 

  107. Fjellbirkeland L, Gulsvik A, Palmer JBD. The efficacy and tolerability of inhaled salmeterol and individually dose–titrated–sustained–release theophylline in patients with reversible airways disease. Respir Med 1994 Sep; 88: 599–607

    Article  PubMed  CAS  Google Scholar 

  108. Bucca C, Rolla G, Brussino L, et al. Inhaled salmeterol versus oral ketolifen in mild–to–moderate asthma. Eur J Clin Res 1995: 7: 57–71

    Google Scholar 

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Various sections of the manuscript reviewed by: M.L. Burr, University of Wales College of Medicine, Temple of Peace and Health, Cardiff, Wales; M.J. Buxton, Health Economics Research Group, Brunei University, Uxbridge, England; P.W. Jones, Division of Physiological Medicine, St George’s Hospital Medical School, London, England; M.E. Hyland, Faculty of Human Sciences, Department of Psychology, University of Plymouth, Plymouth, England; K.-H. Carlsen, Voksentoppen Center of Asthma and Allergy, University of Oslo, National Hospital of Children’s Asthma, Allergy and Chronic Lung Diseases, Oslo, Norway; E. Juniper, McMaster University Medical Centre, Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada; C.M. Mellis, Royal Alexandra Hospital for Children, Department of Respiratory Medicine, Camperdown, New South Wales, Australia; D.S. Pearlman, Colorado Asthma and Allergy Clinic, Aurora, Colorado, USA; B.H. Rowe, Northeastern Ontario Family Medicine Residency Program, Health Science Resource Education Centre, Laurentian University, Sudbury, Ontario, Canada; M.P.M.H. Rutten-van Mölken, Department of Health Economics, University of Limburg, Maastricht, The Netherlands; A. Siracusa, Istuto di Medicina del Lavoro, Università di Perugia, Perugia, Italy; C. Trautner, Diabetes Research Unit at Düsseldorf University, Department of Biometrics and Epidemiology, Düsseldorf, Germany; K.B. Weiss, Rush-Presbyterian-St Luke’s Medical Center, Primary Care institute, Center for Health Services Research, Chicago, Illinois, USA; M. Yamakido, Hiroshima University School of Medicine, Hiroshima, Japan.

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Peters, D.H., Faulds, D. Salmeterol. Pharmacoeconomics 7, 562–574 (1995). https://doi.org/10.2165/00019053-199507060-00010

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