Cost-Effectiveness Analysis of Salmeterol/Fluticasone Propionate 50/250μg vs Fluticasone Propionate 250μg in Adults and Adolescents with Asthma IV: Results

Abstract

Methods: Results from a multicentre clinical trial were used to determine the relative cost effectiveness of a new asthma treatment combining salmeterol 50μg with fluticasone propionate (FP) 250μg in one inhaler and administered twice daily (n = 81) and FP 250μg twice daily (n = 81) in adults and adolescents with moderate to severe asthma. The economic analysis was conducted from the perspective of the Swedish healthcare system.

Results: Treatment with the salmeterol/FP combination product (SFC) resulted in more than double the proportion of successfully treated weeks, defined as a ≥5% improvement in predicted peak expiratory flow (74.5 vs 35.1%; p < 0.00001), and significantly higher proportions of episode-free days (43.5 vs 25.2%; p = 0.0004), and symptom-free days (55.2 vs 37.1%; p = 0.0017) than treatment with FP alone. Total costs of asthma management were similar in both treatment arms [SEK20.9 ($US2.54) per patient per day in the SFC arm and SEK20.2 ($US2.45) per patient per day in the FP arm]. As a consequence, and despite higher drug acquisition costs for the combination product, the cost-effectiveness ratios for successfully treated weeks [SEK196.3 ($US23.82) vs SEK404.5 ($US49.08)], episode-free days [SEK48.1 ($US5.84) vs SEK80.1 ($US9.72)] and symptom-free days [SEK37.8 ($US4.59) vs SEK54.5 ($US6.61)] consistently favoured the SFC group. The additional costs to achieve an additional successfully treated week, symptom-free day and episode-free day were SEK12.6 ($US1.53) per patient per week, SEK3.9 ($US0.47) per patient per day and SEK3.9 ($US0.47) per patient per day, respectively. Sensitivity analyses showed that all outcomes were stable over a range of assumptions.

Conclusion: In summary, SFC 50/250μg was clinically more effective for a similar overall healthcare cost and was therefore more cost effective than FP 250μg in the treatment of asthma in this study.