Comparison of prevalence, cost, and outcomes of a combination of salmeterol and fluticasone therapy to common asthma treatments.
OBJECTIVE
To compare a combination of salmeterol and fluticasone with common asthma pharmacologic regimens used in real-world clinical practice, and to evaluate the associated costs and outcomes of care.


METHODS
Cross-sectional examination of medical and pharmacy claims.


METHODS
The study population included 33,939 adult asthmatics (at least 12 years of age) continuously enrolled in 1 of 4 participating health plans for the 6-month study period. Every subject was in 1 of 10 different pharmacotherapy treatment groups. Univariate and multivariate analyses were used to compare the rates and costs of pharmaceutical prescriptions and medical care services between patients on salmeterol plus fluticasone and patients with other pharmacologic therapies.


RESULTS
About 60.4% of the patients were on single controllers; the balance was on short-acting beta 2-agonists alone (23%) or double controllers (16.8%). The average overall cost of asthma care was approximately $228 per patient over the 6 months of the study. Pharmaceutical cost was the major cost driver, which was significantly lower for single-controller (mean = $134) than for double-controller therapies (mean = $325). However, total costs were $50-$200 lower (P < .029) for patients on salmeterol plus fluticasone and inhaled steroids plus mast cell stabilizing agents than for those on other double controllers.


CONCLUSIONS
Single-controller regimens and short-acting beta-agonists were less costly than double-controller regimens. Within the double-controller groups, salmeterol plus fluticasone appeared to be less costly than other double controllers, except inhaled steroids plus mast cell stabilizing agents.
Wang
S W
SW
Health Benchmarks, Inc., 21650 Oxnard Street, Suite 2150, Woodland Hills, CA 91367, USA.
Liu
X
X
Wiener
D J
DJ
Sennett
C
C
Bowers
B W
BW
Legorreta
A P
AP
D000328:Adult; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use*; D000730:Androstadienes / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D017281:Cost of Illness; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D000068299:Salmeterol Xinafoate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D000420:Albuterol