title: Inhaled corticosteroids vs leukotriene receptor antagonists: health care costs across varying asthma severities.
abstract: BACKGROUND
  The burden of asthma is substantial, and the overall cost of its management is growing.
  
  
  OBJECTIVE
  To compare asthma-related charges and resource utilization across disease severity levels in the year after initial asthma treatment with any inhaled corticosteroid (ICS) or leukotriene receptor antagonist (LTRA).
  
  
  METHODS
  This was a longitudinal, retrospective cohort study of claims data from managed care plans in the United States. All patients had a new prescription for an ICS or an LTRA between January 1999 and December 2000 and were enrolled in a managed care plan for at least 12 months before (preindex) and 12 months after (postindex) the initial claim. Asthma-related charges, hospitalizations, emergency department (ED) visits, physician visits, and asthma medication use were compared between the 2 cohorts. Propensity scores were calculated to control for baseline differences in patient characteristics and types of health care coverage.
  
  
  RESULTS
  Claims from 31,860 patients were evaluated. Total postindex asthma-related charges were significantly lower in the ICS cohort than in the LTRA cohort (dollars 613 vs dollars 902, respectively; P < .001), as were asthma-related pharmacy charges (dollars 305 vs dollars 564, respectively; P < .001). Results were consistent for all propensity subclasses and all age groups.
  
  
  CONCLUSIONS
  Results from this cohort study suggest that, across varying disease severities, treating asthma with an ICS as initial controller therapy leads to less health care resource utilization than does using an LTRA as initial therapy.
authors.affiliation: University of California-San Diego, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: O'Connor
authors.forename: Bhash
authors.initials: B
authors.lastname: Parasuraman
authors.forename: Craig
authors.initials: C
authors.lastname: Roberts
authors.forename: Christopher
authors.initials: C
authors.lastname: Leibman
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000191:economics*; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000191:economics*; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D020024:Leukotriene Antagonists