The cost-effectiveness of inhaled fluticasone propionate and budesonide inthe treatment of asthma in adults and children

Inhaled corticosteroids form the mainstay of the treatment and management o f asthma and the results of a meta-analysis comparing two of the most frequ ently prescribed inhaled corticosteroids, fluticasone propionate and budeso nide, administered in a clinically equivalent 1:2 dose ratio to 1980 patien ts with asthma, demonstrated that fluticasone propionate had an improved ef ficacy:safety ratio. However, limited data are available on the relative ec onomic benefits of fluticasone propionate and budesonide. The database for clinically relevant parameters, for which the efficacy:safety meta-analysis had demonstrated statistical significance between the two corticosteroids, was used for this pharmacoeconomic analysis. Treatment with fluticasone pr opionate was more cost-effective than budesonide with respect to improvemen t in morning peak expiratory flow rate, successfully treated weeks, symptom -free days, symptom-free 24 h and episode-free days. The costs of treatment for fluticasone propionate and budesonide were pound 7.78 per week and pou nd 12.33 per week, respectively. The main contributing factor to the higher costs of budesonide was the higher cost of health care contacts, which wer e pound 4.53 per week for budesonide and pound 0.57 per week for fluticason e propionate. The pharmacoeconomic difference increased in favour of flutic asone propionate as the criteria for success were made more stringent. Thes e results demonstrate that, for asthma patients requiring modification of t herapy treatment with fluticasone propionate is more effective and also che aper, in terms of overall health-care costs, than treatment with budesonide .