Abstract
Objective: To compare the cost effectiveness of hydrofluoroalkane 134a-beclomethasone dipropionate (HFA-BDP; Quae(TM)) with chlorofluorocarbonbeclomethasone dipropionate (CFC-BDP) in patients with chronic stable asthma previously receiving CFC-BDP, from the perspective of a healthcare provider.
Design: Cost-effectiveness analysis based on a 12-month pragmatic, randomised, parallel group, open-label clinical trial assessing safety and efficacy of HFA-BDP at approximately half the dose of CFC-BDP in patients with stable asthma.
Setting: International, multicentre study at 57 study sites in the US, UK, The Netherlands, and Belgium. Healthcare costs were calculated for UK-based healthcare [in 1999 as pounds (pound)].
Patients and Participants: Patients (n=473) greater than or equal to12 years of age with currently stable asthma that had been stable (i.e. no exacerbations requiring oral corticosteroid use in the last 4 weeks) for at least the preceding month.
Main Outcome Measures: Average and incremental cost-effectiveness ratios based upon symptom-free days, improvement in health-related quality of life, and total and drug-only direct healthcare costs.
Results: Patients in the HFA-BDP group experienced a significantly higher percentage of symptom-free days than patients in the CFC-BDP group by the end of the study period (42.4 vs 20.0%; p=0.006). A greater percentage of patients in the HFA-BDP group had a clinically significant improvement in health-related quality of life than in the CFC-BDP group [35.3 (n=116/329) vs 16.1% (n=18/112)]. Total per patient healthcare costs were similar between the two groups. The average cost per symptom-free day per patient was pound1.36 for HFA-BDP and pound1.81 for CFC-BDP based on total healthcare costs. The incremental cost per symptom-free day for using HFA-BDP instead of CFC-BDP was negative, indicating that HFA-BDP is a dominant strategy and may be a cost-saving intervention compared with CFC-BDP. A sensitivity analysis varying both cost and outcome parameters further supported this finding for most scenarios tested. The cost to achieve a clinically significant improvement in health-related quality of life over the study period was pound13.24 per improved patient per week for HFA-BDP and pound29.38 per patient per week for CFC-BDP.
Conclusions: These findings indicate that HFA-BDP is a cost-effective intervention when compared with CFC-BDP in this group of patients with stable asthma. In the majority of scenarios HFA-BDP provides more effective asthma control at a similar cost to CFC-BDP.
| Original language | English |
|---|---|
| Pages (from-to) | 653-664 |
| Number of pages | 11 |
| Journal | Pharmacoeconomics |
| Volume | 20 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2002 |
Keywords
- FLUTICASONE PROPIONATE
- EXTRAFINE AEROSOL
- MODERATE ASTHMA
- OF-LIFE
- TRIALS
- FORMOTEROL
- EFFICACY
- OUTCOMES
- CHILDREN
- THERAPY
Cite this
The cost effectiveness of chlorofluorocarbon-free beclomethasone dipropionate in the treatment of chronic asthma: a cost model based on a 1-year pragmatic, randomised clinical study. / Price, David Brendan; Haughney, John Andrew Francis; Nicholls, C.; Duerden, M.; Moseley, C.
In: Pharmacoeconomics, Vol. 20, No. 10, 2002, p. 653-664.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The cost effectiveness of chlorofluorocarbon-free beclomethasone dipropionate in the treatment of chronic asthma: a cost model based on a 1-year pragmatic, randomised clinical study
AU - Price, David Brendan
AU - Haughney, John Andrew Francis
AU - Nicholls, C.
AU - Duerden, M.
AU - Moseley, C.
PY - 2002
Y1 - 2002
N2 - Objective: To compare the cost effectiveness of hydrofluoroalkane 134a-beclomethasone dipropionate (HFA-BDP; Quae(TM)) with chlorofluorocarbonbeclomethasone dipropionate (CFC-BDP) in patients with chronic stable asthma previously receiving CFC-BDP, from the perspective of a healthcare provider.Design: Cost-effectiveness analysis based on a 12-month pragmatic, randomised, parallel group, open-label clinical trial assessing safety and efficacy of HFA-BDP at approximately half the dose of CFC-BDP in patients with stable asthma.Setting: International, multicentre study at 57 study sites in the US, UK, The Netherlands, and Belgium. Healthcare costs were calculated for UK-based healthcare [in 1999 as pounds (pound)].Patients and Participants: Patients (n=473) greater than or equal to12 years of age with currently stable asthma that had been stable (i.e. no exacerbations requiring oral corticosteroid use in the last 4 weeks) for at least the preceding month.Main Outcome Measures: Average and incremental cost-effectiveness ratios based upon symptom-free days, improvement in health-related quality of life, and total and drug-only direct healthcare costs.Results: Patients in the HFA-BDP group experienced a significantly higher percentage of symptom-free days than patients in the CFC-BDP group by the end of the study period (42.4 vs 20.0%; p=0.006). A greater percentage of patients in the HFA-BDP group had a clinically significant improvement in health-related quality of life than in the CFC-BDP group [35.3 (n=116/329) vs 16.1% (n=18/112)]. Total per patient healthcare costs were similar between the two groups. The average cost per symptom-free day per patient was pound1.36 for HFA-BDP and pound1.81 for CFC-BDP based on total healthcare costs. The incremental cost per symptom-free day for using HFA-BDP instead of CFC-BDP was negative, indicating that HFA-BDP is a dominant strategy and may be a cost-saving intervention compared with CFC-BDP. A sensitivity analysis varying both cost and outcome parameters further supported this finding for most scenarios tested. The cost to achieve a clinically significant improvement in health-related quality of life over the study period was pound13.24 per improved patient per week for HFA-BDP and pound29.38 per patient per week for CFC-BDP.Conclusions: These findings indicate that HFA-BDP is a cost-effective intervention when compared with CFC-BDP in this group of patients with stable asthma. In the majority of scenarios HFA-BDP provides more effective asthma control at a similar cost to CFC-BDP.
AB - Objective: To compare the cost effectiveness of hydrofluoroalkane 134a-beclomethasone dipropionate (HFA-BDP; Quae(TM)) with chlorofluorocarbonbeclomethasone dipropionate (CFC-BDP) in patients with chronic stable asthma previously receiving CFC-BDP, from the perspective of a healthcare provider.Design: Cost-effectiveness analysis based on a 12-month pragmatic, randomised, parallel group, open-label clinical trial assessing safety and efficacy of HFA-BDP at approximately half the dose of CFC-BDP in patients with stable asthma.Setting: International, multicentre study at 57 study sites in the US, UK, The Netherlands, and Belgium. Healthcare costs were calculated for UK-based healthcare [in 1999 as pounds (pound)].Patients and Participants: Patients (n=473) greater than or equal to12 years of age with currently stable asthma that had been stable (i.e. no exacerbations requiring oral corticosteroid use in the last 4 weeks) for at least the preceding month.Main Outcome Measures: Average and incremental cost-effectiveness ratios based upon symptom-free days, improvement in health-related quality of life, and total and drug-only direct healthcare costs.Results: Patients in the HFA-BDP group experienced a significantly higher percentage of symptom-free days than patients in the CFC-BDP group by the end of the study period (42.4 vs 20.0%; p=0.006). A greater percentage of patients in the HFA-BDP group had a clinically significant improvement in health-related quality of life than in the CFC-BDP group [35.3 (n=116/329) vs 16.1% (n=18/112)]. Total per patient healthcare costs were similar between the two groups. The average cost per symptom-free day per patient was pound1.36 for HFA-BDP and pound1.81 for CFC-BDP based on total healthcare costs. The incremental cost per symptom-free day for using HFA-BDP instead of CFC-BDP was negative, indicating that HFA-BDP is a dominant strategy and may be a cost-saving intervention compared with CFC-BDP. A sensitivity analysis varying both cost and outcome parameters further supported this finding for most scenarios tested. The cost to achieve a clinically significant improvement in health-related quality of life over the study period was pound13.24 per improved patient per week for HFA-BDP and pound29.38 per patient per week for CFC-BDP.Conclusions: These findings indicate that HFA-BDP is a cost-effective intervention when compared with CFC-BDP in this group of patients with stable asthma. In the majority of scenarios HFA-BDP provides more effective asthma control at a similar cost to CFC-BDP.
KW - FLUTICASONE PROPIONATE
KW - EXTRAFINE AEROSOL
KW - MODERATE ASTHMA
KW - OF-LIFE
KW - TRIALS
KW - FORMOTEROL
KW - EFFICACY
KW - OUTCOMES
KW - CHILDREN
KW - THERAPY
U2 - 10.2165/00019053-200220100-00002
DO - 10.2165/00019053-200220100-00002
M3 - Article
VL - 20
SP - 653
EP - 664
JO - Pharmacoeconomics
JF - Pharmacoeconomics
SN - 1170-7690
IS - 10
ER -