title: Clinical outcomes and treatment cost comparison of levalbuterol versus albuterol in hospitalized adults with chronic obstructive pulmonary disease or asthma.
abstract: OBJECTIVE
  Results of a prospective study comparing clinical outcomes and costs of levalbuterol versus albuterol therapy for exacerbations of asthma or chronic obstructive pulmonary disease (COPD) are presented.
  
  
  METHODS
  In a single-center open-label study, selected adults hospitalized for asthma or COPD exacerbations over a 21-month period were randomly assigned to receive levalbuterol 1.25 mg three times daily (n = 55) or albuterol 2.5 mg four times daily (n = 57); dosage reductions and other respiratory therapies were permitted. Study outcomes included scheduled and rescue nebulizations, total treatment costs, hospital length of stay, and change in heart rate from baseline.
  
  
  RESULTS
  The numbers of scheduled nebulizations were similar in the levalbuterol and albuterol groups (mean ± S.D., 19.6 ± 13.4 versus 20.7 ± 14.4; p = 0.692), as were the numbers of rescue nebulizations (mean ± S.D., 0.7 ± 1.4 versus 0.8 ± 2.0; p = 0.849). The mean change from baseline in heart rate did not differ significantly between groups. Mean total treatment costs per patient were significantly greater with the use of levalbuterol ($8003, bootstrap 95% confidence interval [CI], $6628-$9379) versus albuterol ($5772, bootstrap 95% CI, $5051-$6494; p = 0.006). Hospital length of stay was significantly greater in the levalbuterol group (mean ± S.D., 8.5 ± 5.2 days versus 6.8 ± 3.6 days with albuterol use; p = 0.040).
  
  
  CONCLUSIONS
  Clinical outcomes were similar with the use of levalbuterol versus albuterol for exacerbations of COPD or asthma. On average, patients receiving levalbuterol had longer and more costly hospital stays.
authors.affiliation: Luigi Brunetti, Pharm.D., M.P.H., is Clinical Associate Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, and Clinical Pharmacy Specialist, Internal Medicine, Robert Wood Johnson University Hospital-Somerset, Somerville, NJ. George Poiani, M.D., FACP, FCCP, is Attending Physician, Department of Medicine, Robert Wood Johnson University Hospital-Somerset, and Clinical Associate Professor, Division of Pulmonary/Critical Care Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ. Fatema Dhanaliwala, B.S.Pharm., is Pharmacy Supervisor, Department of Pharmacy, Robert Wood Johnson University Hospital-Somerset. Kristen Poppiti, Pharm.D., is Postgraduate Year 1 Pharmacy Resident, Inova Fairfax Hospital, Falls Church, VA; at the time of writing, she was a Pharm.D. student in the Honors Research Program at Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey. Haenam Kang, B.S., is Graduate Student, College of Pharmacy; and Dong-Churl Suh, M.B.A., Ph.D., is Professor, College of Pharmacy, Chung-Ang University, Seoul, South Korea.
authors.forename: Luigi
authors.initials: L
authors.lastname: Brunetti
authors.affiliation: Luigi Brunetti, Pharm.D., M.P.H., is Clinical Associate Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, and Clinical Pharmacy Specialist, Internal Medicine, Robert Wood Johnson University Hospital-Somerset, Somerville, NJ. George Poiani, M.D., FACP, FCCP, is Attending Physician, Department of Medicine, Robert Wood Johnson University Hospital-Somerset, and Clinical Associate Professor, Division of Pulmonary/Critical Care Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ. Fatema Dhanaliwala, B.S.Pharm., is Pharmacy Supervisor, Department of Pharmacy, Robert Wood Johnson University Hospital-Somerset. Kristen Poppiti, Pharm.D., is Postgraduate Year 1 Pharmacy Resident, Inova Fairfax Hospital, Falls Church, VA; at the time of writing, she was a Pharm.D. student in the Honors Research Program at Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey. Haenam Kang, B.S., is Graduate Student, College of Pharmacy; and Dong-Churl Suh, M.B.A., Ph.D., is Professor, College of Pharmacy, Chung-Ang University, Seoul, South Korea.
authors.forename: George
authors.initials: G
authors.lastname: Poiani
authors.affiliation: Luigi Brunetti, Pharm.D., M.P.H., is Clinical Associate Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, and Clinical Pharmacy Specialist, Internal Medicine, Robert Wood Johnson University Hospital-Somerset, Somerville, NJ. George Poiani, M.D., FACP, FCCP, is Attending Physician, Department of Medicine, Robert Wood Johnson University Hospital-Somerset, and Clinical Associate Professor, Division of Pulmonary/Critical Care Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ. Fatema Dhanaliwala, B.S.Pharm., is Pharmacy Supervisor, Department of Pharmacy, Robert Wood Johnson University Hospital-Somerset. Kristen Poppiti, Pharm.D., is Postgraduate Year 1 Pharmacy Resident, Inova Fairfax Hospital, Falls Church, VA; at the time of writing, she was a Pharm.D. student in the Honors Research Program at Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey. Haenam Kang, B.S., is Graduate Student, College of Pharmacy; and Dong-Churl Suh, M.B.A., Ph.D., is Professor, College of Pharmacy, Chung-Ang University, Seoul, South Korea.
authors.forename: Fatema
authors.initials: F
authors.lastname: Dhanaliwala
authors.affiliation: Luigi Brunetti, Pharm.D., M.P.H., is Clinical Associate Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, and Clinical Pharmacy Specialist, Internal Medicine, Robert Wood Johnson University Hospital-Somerset, Somerville, NJ. George Poiani, M.D., FACP, FCCP, is Attending Physician, Department of Medicine, Robert Wood Johnson University Hospital-Somerset, and Clinical Associate Professor, Division of Pulmonary/Critical Care Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ. Fatema Dhanaliwala, B.S.Pharm., is Pharmacy Supervisor, Department of Pharmacy, Robert Wood Johnson University Hospital-Somerset. Kristen Poppiti, Pharm.D., is Postgraduate Year 1 Pharmacy Resident, Inova Fairfax Hospital, Falls Church, VA; at the time of writing, she was a Pharm.D. student in the Honors Research Program at Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey. Haenam Kang, B.S., is Graduate Student, College of Pharmacy; and Dong-Churl Suh, M.B.A., Ph.D., is Professor, College of Pharmacy, Chung-Ang University, Seoul, South Korea.
authors.forename: Kristen
authors.initials: K
authors.lastname: Poppiti
authors.affiliation: Luigi Brunetti, Pharm.D., M.P.H., is Clinical Associate Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, and Clinical Pharmacy Specialist, Internal Medicine, Robert Wood Johnson University Hospital-Somerset, Somerville, NJ. George Poiani, M.D., FACP, FCCP, is Attending Physician, Department of Medicine, Robert Wood Johnson University Hospital-Somerset, and Clinical Associate Professor, Division of Pulmonary/Critical Care Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ. Fatema Dhanaliwala, B.S.Pharm., is Pharmacy Supervisor, Department of Pharmacy, Robert Wood Johnson University Hospital-Somerset. Kristen Poppiti, Pharm.D., is Postgraduate Year 1 Pharmacy Resident, Inova Fairfax Hospital, Falls Church, VA; at the time of writing, she was a Pharm.D. student in the Honors Research Program at Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey. Haenam Kang, B.S., is Graduate Student, College of Pharmacy; and Dong-Churl Suh, M.B.A., Ph.D., is Professor, College of Pharmacy, Chung-Ang University, Seoul, South Korea.
authors.forename: Haenam
authors.initials: H
authors.lastname: Kang
authors.affiliation: Luigi Brunetti, Pharm.D., M.P.H., is Clinical Associate Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, and Clinical Pharmacy Specialist, Internal Medicine, Robert Wood Johnson University Hospital-Somerset, Somerville, NJ. George Poiani, M.D., FACP, FCCP, is Attending Physician, Department of Medicine, Robert Wood Johnson University Hospital-Somerset, and Clinical Associate Professor, Division of Pulmonary/Critical Care Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ. Fatema Dhanaliwala, B.S.Pharm., is Pharmacy Supervisor, Department of Pharmacy, Robert Wood Johnson University Hospital-Somerset. Kristen Poppiti, Pharm.D., is Postgraduate Year 1 Pharmacy Resident, Inova Fairfax Hospital, Falls Church, VA; at the time of writing, she was a Pharm.D. student in the Honors Research Program at Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey. Haenam Kang, B.S., is Graduate Student, College of Pharmacy; and Dong-Churl Suh, M.B.A., Ph.D., is Professor, College of Pharmacy, Chung-Ang University, Seoul, South Korea. dongsuh75@gmail.com.
authors.forename: Dong-Churl
authors.initials: DC
authors.lastname: Suh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000191:economics; D001993:Bronchodilator Agents / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D064412:Levalbuterol / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000191:economics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001993:Bronchodilator Agents; D064412:Levalbuterol; D000420:Albuterol