title: Cost-effectiveness of fluticasone propionate administered via metered-dose inhaler plus babyhaler spacer in the treatment of asthma in preschool-aged children.
abstract: OBJECTIVE
  To evaluate the cost-effectiveness of inhaled fluticasone propionate (FP) in children aged 12 to 47 months with asthma symptoms.
  
  
  METHODS
  A retrospective economic analysis conducted from the perspective of the Danish health-care system, based on clinical data from a 12-week study.
  
  
  METHODS
  Thirty-three outpatient centers in nine countries.
  
  
  METHODS
  Two hundred thirty-seven children aged 12 to 47 months with documented history of recurrent wheeze or asthma symptoms.
  
  
  METHODS
  Two dosages of FP, 100 microg/d and 200 microg/d, and placebo administered in two divided doses via a metered-dose inhaler and a Babyhaler (Glaxo Wellcome; Middlesex, UK) spacer device.
  
  
  METHODS
  Effectiveness in terms of asthma exacerbations, control of cough and wheeze symptoms, symptom-free days, overall direct costs of asthma management in Danish kroner at 1999 prices, and mean and incremental cost-effectiveness ratios.
  
  
  RESULTS
  FP, 200 microg/d, was significantly more effective than placebo treatment in terms of the proportion of exacerbation-free patients (73.7% vs 59.8%; p = 0.025) and patients experiencing a > or = 25% improvement in cough symptoms (57.9% vs 39.0%; p = 0.018). The costs per exacerbation-free patient, per patient with a > or = 25% improvement in cough and wheeze symptoms from baseline, and per symptom-free day were lower in the FP groups than in the placebo group. The incremental cost-effectiveness ratios for these end points indicated that the additional benefits of FP, 200 microg/d, were achieved at a lower overall cost compared with placebo treatment.
  
  
  CONCLUSIONS
  From the perspective of the Danish health-care system, FP, 100 microg bid, administered via the Babyhaler inhalation device was cost-effective relative to standard therapy with bronchodilators alone.
authors.affiliation: Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Bisgaard@copsac.dk
authors.forename: H
authors.initials: H
authors.lastname: Bisgaard
authors.forename: M J
authors.initials: MJ
authors.lastname: Price
authors.forename: C
authors.initials: C
authors.lastname: Maden
authors.forename: N A
authors.initials: NA
authors.lastname: Olsen
mesh_terms: D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D001249:Asthma / Q000188:drug therapy / Q000191:economics*; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003718:Denmark; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D000068298:Fluticasone; D006801:Humans; D007223:Infant; D008297:Male; D009313:National Health Programs / Q000191:economics; D009330:Nebulizers and Vaporizers / Q000191:economics*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D000068298:Fluticasone