title: FP/FORM Versus FP/SAL Within Clinical Practice: An Updated Budget Impact Analysis in Asthma.
abstract: Pressurized metered-dose inhalers (pMDI) such as fluticasone propionate and salmeterol (FP/SAL) are commonly used for the treatment of asthma in the UK. Previously, a budget impact analysis demonstrated that use of FP and formoterol fumarate (FP/FORM) pMDI as an alternative to FP/SAL pMDI, would be a cost-saving option for the UK National Health Service (NHS). This budget impact analysis aimed to update the existing analysis with prescription volume data and real-world evidence since the introduction of FP/FORM to the UK market.
  
  
  
  Patient Data (IMS Information Solutions UK Ltd) moving annual total (MAT) August 2015 were used to ascertain the number of units of pMDI prescribed. Annual costs to the NHS in terms of drug, administration, monitoring and adverse event costs, were used to estimate the potential budget impact for FP/FORM and FP/SAL. Costs were calculated for current prescription volumes (12% FP/FORM, 88% FP/SAL), and for different prescription volume scenarios (FP/FORM at 0%, 25%, 50% and 100%). Real-world evidence and budget impact at a clinical commissioning group (CCG) level were also considered.
  
  
  
  Total annual costs per person year were less with FP/FORM (£625) than with FP/SAL (£734). Annual costs to the NHS based on the current prescription volumes and clinical trial data were estimated at £210.0M, however, based on real-world evidence, costs were estimated at £179.8M. For all scenarios with increased FP/FORM prescription volumes, the annual total costs to the NHS decreased. This was reflected at a CCG level.
  
  
  
  The use of FP/FORM as an alternative to FP/SAL can result in cost savings for the NHS when assessing drug, administration, monitoring and adverse events costs. The inclusion of data released since the launch of FP/FORM within the budget impact analysis demonstrates that the potential cost savings to the NHS that were previously published are being translated to clinical practice.
  
  
  
  Mundipharma, UK.
authors.affiliation: Adelphi Values, Adelphi Mill, Bollington, Macclesfield, Cheshire, SK10 5JB, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Farrington
authors.affiliation: BioExcel Limited, Beckley Manor, Beckley, Oxford, OX3 9TG, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Saunders
authors.affiliation: Adelphi Values, Adelphi Mill, Bollington, Macclesfield, Cheshire, SK10 5JB, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Heron
authors.affiliation: Mundipharma International, Unit 194, Cambridge Science Park, Milton Road, Cambridge, CB4 0AB, UK. will.dunlop@mundipharma.co.uk.
authors.forename: William
authors.initials: W
authors.lastname: Dunlop
mesh_terms: D001249:Asthma / Q000188:drug therapy / Q000191:economics; D017046:Cost Savings / Q000379:methods*; D016903:Drug Monitoring / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology; D000068297:Fluticasone-Salmeterol Drug Combination / Q000191:economics / Q000494:pharmacology; D000068759:Formoterol Fumarate / Q000191:economics / Q000494:pharmacology; D062489:Health Impact Assessment; D006801:Humans; D036501:Metered Dose Inhalers; D018803:Models, Economic; D013222:State Medicine; D006113:United Kingdom
chemical_list: D000068297:Fluticasone-Salmeterol Drug Combination; D000068759:Formoterol Fumarate
keywords: Asthma; Budget; Cost; Fluticasone propionate; Formoterol; Pulmonology; Salmeterol