Source: Annual Congress 2002 - Asthma - Therapy and management -1
Disease area: Airway diseases

Abstract

Multinational data on the cost-effectiveness of early intervention with inhaled corticosteroids in newly diagnosed asthma is not available.
Methods: Using data from the 3-year prospective, randomised START study, we estimated the cost-effectiveness of budesonide (Pulmicort® Turbuhaler® 200 or 400 μg O.D.) compared to placebo on top of usual care in 7165 patients aged 5 to 66 years. Cost included regular treatment and emergency healthcare utilization for asthma, medications and days missed from school/work. Unit costs for 8 selected countries were applied to the full dataset (reported in 1999 Purchasing Power Parity-adjusted US$). Incremental cost-effectiveness ratios (ICER) were estimated as cost per symptom-free day (SFD) gained.
Results: When compared to usual care, patients receiving budesonide experienced an annual average of 14 more SFDs (p<0.001), had 69% fewer hospital days (p<0.001) and 67% fewer emergency-room visits (p<0.05). From a healthcare payer perspective, budesonide reduced the total cost of asthma care in Australia. In Sweden, Canada, France, Spain, UK, China and the US, the ICER ranged from $2.4-$11.3 per SFD. From a societal perspective, budesonide was cost-saving in Canada, Sweden and Australia, and cost-effective in the other 5 countries.
Conclusion: Early intervention with budesonide can be considered cost-effective in mild persistent asthma, and potentially cost-saving in some countries, depending upon relative price structures.

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M. Buxton, S. D. Sullivan, L. F. Andersson, C. J. Lamm, B. Liljas, W. W. Busse, S. Pedersen, K. B. Weiss (Uxbridge, United Kingdom; Seattle, Madison, Chicago, United States Of America; Lund, Sweden; Kolding, Denmark). The cost-effectiveness of early intervention with inhaled budesonide once daily: an international comparison of the results from the START study. Eur Respir J 2002; 20: Suppl. 38, 387

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