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Cost-Effectiveness Analyses of Salmeterol/Fluticasone Propionate Combination Product and Fluticasone Propionate in Patients with Asthma I: Introduction and Overview

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Abstract

When a new drug therapy is introduced, it is important to consider the economic impact of the treatment. This is particularly relevant for a chronic disease such as asthma. Despite an increased understanding of the physiology of asthma, this condition remains an important cause of morbidity and mortality in many countries and places a large financial burden on healthcare systems.

An economic analysis was performed to determine the cost effectiveness of 3 strengths of a new salmeterol/fluticasone propionate combination product (SFC): 50/100, 50/250 and 50/500mg twice daily relative to the equivalent dose of fluticasone propionate (FP) alone (100, 250 or 500μg twice daily, respectively). The economic analysis was performed using 12-week data from 3 randomised controlled clinical trials in adults and adolescents with asthma. The analysis was conducted from the perspective of the Swedish healthcare system and only direct costs were considered. Data from daily diaries showed that all 3 strengths of SFC were associated with a significantly higher proportion of successfully treated weeks (defined as a ≥5% improvement in predicted peak expiratory flow, compared with baseline) than FP alone. The cost per successfully treated week was lower for all 3 strengths of the combination product than for the equivalent dose of FP alone [SEK150.9 to 365.1 ($US18.31 to 44.30) vs SEK169.0 to 487.8 ($US20.50 to 59.18)], despite higher drug costs associated with the former. The incremental cost-effectiveness ratios showed that the costs to achieve an additional successfully treated week with SFC were SEK133.4 ($US16.18), SEK12.6 ($US1.53) and SEK192.1 ($US23.31) for the 50/100, 50/250 and 50/50μg strengths, respectively. Sensitivity analysis indicated that these results were robust over a wide range of assumptions. Thus, in the Swedish healthcare setting SFC 50/100, 50/250 and 50/500μg are more cost effective than the equivalent doses of FP alone in patients with asthma.

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Authors and Affiliations

  1. Respiratory Unit, National Institute for Working Life, Stockholm/Solna and Umeå, Sweden

    Bo Lundbäck

  2. Elkerliek Ziekenhuis, Helmond, The Netherlands

    Willem R. Pieters

  3. Nyby Health Care Centre, Uppsala, Sweden

    Gunnar Johansson

  4. Department of Respiratory Medicine and Allergology, Göteborg University, Sahlgrenska University Hospital, Göteborg, Sweden

    Mona Palmqvist

  5. Global Health Outcomes, Glaxo Wellcome, Greenford Road, Greenford, Middlesex, UB6 0HE, England

    Martin J. Price, Seema Sondhi & Robert M.A. Thwaites

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  1. Bo Lundbäck
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  4. Mona Palmqvist
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  5. Martin J. Price
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  6. Seema Sondhi
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  7. Robert M.A. Thwaites
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Lundbäck, B., Pieters, W.R., Johansson, G. et al. Cost-Effectiveness Analyses of Salmeterol/Fluticasone Propionate Combination Product and Fluticasone Propionate in Patients with Asthma I: Introduction and Overview. Pharmacoeconomics 16 (Suppl 2), 1–8 (1999). https://doi.org/10.2165/00019053-199916002-00001

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  • DOI: https://doi.org/10.2165/00019053-199916002-00001

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