title: Hydrofluoroalkane-134a beclomethasone as a dominant economic asthma therapy.
abstract: Inhaled corticosteroids for asthma treatment have become mainstay of therapy for patients with persistent asthma. Numerous inhaled corticosteroids are available but to date no prospective cost-effectiveness studies have been reported using exclusively US patients and costs. The purpose of this study was to examine the cost-effectiveness of HFA-bectomethasone (QVAR) compared to CFC-beclomethasone (Vanceril) using data from a year-long prospective randomized, open label, parallel multicenter trial. Eligibility criteria required patients to have been on a stable dose of CFC-BDP prior to enrollment. Patients were randomized to either HFA-BDP at approximately half their previous daily dose of CFC-BDP or to continue CFC-BDP Effectiveness data, in terms of symptom-free days (SFDs), were used in a cost-effectiveness analysis conducted from the viewpoint of managed care. Patients receiving HFA-BDP reported a greater increase (median = 22.1) in the number of SFDs than those receiving CFC-BDP (median = 14.3) (P = 0.03). Total costs of care were less for patients taking HFA-BDP (median = dollars 668) compared to CFC-BDP (median = dollars 977). The median incremental cost-effectiveness ratio was dollars -5.77 (95% CI: dollars -68.08 to dollars -4.08). The results of this analysis indicate that HFA-BDP was a dominant therapy (more effective, less costly) compared to CFC-BDP.
authors.affiliation: Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona Health Sciences Center, 1703 E. Mabel Street, Tucson, AZ 85721-0207, USA. malone@pharmacy.arizona.edu
authors.forename: D C
authors.initials: DC
authors.lastname: Malone
authors.forename: A T
authors.initials: AT
authors.lastname: Luskin
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000335:Aerosol Propellants / Q000191:economics*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000191:economics*; D001249:Asthma / Q000188:drug therapy / Q000191:economics* / Q000503:physiopathology; D001507:Beclomethasone / Q000008:administration & dosage / Q000191:economics*; D017402:Chlorofluorocarbons / Q000191:economics; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000191:economics*; D008297:Male; D005466:Fluorocarbons
chemical_list: D000335:Aerosol Propellants; D018927:Anti-Asthmatic Agents; D001507:Beclomethasone; D017402:Chlorofluorocarbons; D006845:Hydrocarbons, Fluorinated; C094049:apaflurane; D005466:Fluorocarbons