Cost-Effectiveness Analysis of Salmeterol/Fluticasone Propionate 50/100μg vs Fluticasone Propionate 100μg in Adults and Adolescents with Asthma III: Results

Abstract

Methods: An economic analysis was performed using data from a 12-week randomised controlled trial to determine the cost effectiveness of a salmeterol/fluticasone propionate combination product (SFC) 50/100μg twice daily (n = 86) relative to fluticasone propionate (FP) 100μg twice daily (n = 85) in adults and adolescents with asthma. The analysis was conducted from the perspective of the Swedish healthcare system.

Results: SFC was associated with a significantly higher proportion of successfully treated weeks (defined as a week with a mean improvement in morning peak expiratory flow of ≥5% compared with predicted baseline values) than FP alone (65 vs 33%; p < 0.00001). Although there were trends in favour of SFC, there were no significant differences between treatments in the proportions of symptom-free and episode-free days. The cost per successfully treated week was lower for the combination product than for FP [SEK151 ($US18.30) vs SEK169 ($US20.50)], despite higher drug costs associated with the former, indicating that, on average, improvements in lung function were achieved at a lower average cost with the combination product than with FP alone. The incremental cost-effectiveness ratio revealed that the cost to achieve an additional successfully treated week with SFC was an additional SEK133.4 ($US16.18) per week. These results were robust over a range of assumptions on sensitivity analysis.

Conclusions: In summary, SFC 50/100μg resulted in significant improvements in lung function compared with FP 100μg alone. These additional benefits were achieved for a modest increase in cost, suggesting that SFC 50/100μg was more cost effective than FP 100μg alone in patients with asthma.