COST-EFFECTIVENESS OF FLUTICASONE AND BUDESONIDE IN PATIENTS WITH MODERATE ASTHMA

Objective: The objective of this study was to assess the relative cost effectiveness of fluticasone via metered dose inhaler and budesonide via Turbuhaler(R) in corticosteroid-naive patients with moderate asthm a from a third-party payer perspective (German Sickness Funds). Patien ts and Methods: A retrospective economic assessment of direct medicati on costs of treatment was performed on data from a prospective, random ised, parallel group, 6-week clinical trial. 457 corticosteroid-naive patients between the ages of 18 and 70 years with moderate asthma were included in the intention-to-treat analysis. Results: The fluticasone group had a higher proportion of successfully treated patients (those with a peak expiratory flow rate improvement of greater than or equal to 10%) [47 vs 42%], a higher average proportion of symptom-free days (40 vs 34%) and lower direct healthcare costs [1997 Deutschmarks (DM) ] per day (DM4.23 vs DM5.19) than the budesonide group. Therefore, the daily costs per successfully treated patient (DM9.00 vs DM12.36) and the cost per symptom-free day (DM10.58 vs DM15.26) were both lower wit h fluticasone than with budesonide. Sensitivity analysis demonstrated that these results were relatively robust over a wide range of plausib le assumptions. Conclusion: These results showed that from the perspec tive of a third-party payer, fluticasone was more cost effective than budesonide over the 6-week study period.