Comparative efficacy and cost of asthma care in children with asthma treated with fluticasone propionate and montelukast.
OBJECTIVE
To assess the comparative efficacy of fluticasone propionate (FP) and montelukast (MON), using administrative claims for pediatric asthma in a clinical setting.


METHODS
This retrospective observational study used the PharMetrics Integrated-Outcomes Database. Children age 4 to 17 years with an ICD-9-CM 493.xx for asthma, therapy with an inhaled corticosteroid in the 12 months before the index medications, and an index claim for FP or MON between January 2001 and December 2003 were studied. FP- and MON-treated children were propensity-matched based on health care utilization. Asthma-related parameters studied included treatment failure, hospitalizations, and total cost of care.


RESULTS
The children treated with MON were more likely to experience treatment failure (odds ratio [OR] = 2.55; 95% confidence interval [CI] = 2.19 to 2.96) and to be admitted to the hospital for asthma-related care (OR = 1.99; 95% CI = 1.15 to 3.44) compared with those treated with FP. Furthermore, the children treated with MON incurred significantly higher asthma-related treatment costs compared with those treated with FP (parameter estimate = 0.418; P < .0001).


CONCLUSIONS
In children with asthma, treatment with FP is associated with better outcomes and lower cost than treatment with MON.
Stempel
David A
DA
Infomed Northwest, Bellevue, WA, USA. econmed@msn.com
Kruzikas
Denise T
DT
Manjunath
Ranjani
R
D000085:Acetates / Q000191:economics / Q000627:therapeutic use*; D000280:Administration, Inhalation; D000293:Adolescent; D000730:Androstadienes / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D003521:Cyclopropanes; D005260:Female; D000068298:Fluticasone; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011336:Probability; D011804:Quinolines / Q000191:economics / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D000730:Androstadienes; D001993:Bronchodilator Agents; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; D000068298:Fluticasone; C093875:montelukast