Asthma: resource use and costs for inhaled corticosteroid vs leukotriene modifier treatment--a meta-analysis.
OBJECTIVE
To compare the effects of inhaled corticosteroid treatment with leukotriene modifier treatment on medical resource use and costs for asthma patients.


METHODS
Meta-analysis combining results from published and unpublished studies.


METHODS
Studies were identified from the MEDLINE and EMBASE databases and the GlaxoSmithKline internal database study registers. Two independent reviewers evaluated the identified studies; studies meeting specified inclusion criteria were abstracted and summarized by meta-analysis with a random effects model.


METHODS
Hospitalization rate, emergency department visit rate, emergency department costs, drug costs, total asthma-related costs, and total medical care costs.


RESULTS
Patients taking inhaled corticosteroids had: a significantly lower annual rate of hospitalization than those taking leukotriene modifiers (2.2% vs 4.3%, respectively; P<.05); a greater decline in hospitalization rate (before vs after therapy initiation) than those taking leukotriene modifiers (decline of 2.4% vs 0.55%; P<.01); a lower annual rate of emergency department visits than those taking leukotriene modifiers (6.2% vs 7.7%; P<.005); lower total asthma-related medical costs than those taking leukotriene modifiers (P<.05) and a 17% reduction in overall total medical care costs (P not significant).


CONCLUSIONS
Patients with asthma treated with inhaled corticosteroids have significantly fewer asthma-related hospitalizations and emergency department visits and lower total asthma-related health care costs than patients treated with leukotriene modifiers. These meta-analysis findings are consistent with results from randomized controlled trials showing improvements in lung function for patients taking inhaled corticosteroids as opposed to leukotriene modifiers.
Halpern
Michael T
MT
Exponent, Inc., 1800 Diagonal Road, Alexandria, VA 22314, USA. mhalpern@exponent.com
Khan
Zeba M
ZM
Stanford
Richard H
RH
Spayde
Katharine M
KM
Golubiewski
Maceij
M
D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000191:economics*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000191:economics*; D001249:Asthma / Q000188:drug therapy*; D016527:Drug Costs / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006302:Health Services Research; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000191:economics*; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D013256:Steroids; D016896:Treatment Outcome; D006113:United Kingdom; D014481:United States
D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D020024:Leukotriene Antagonists; D013256:Steroids