Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin.
Allergy. 2010 Sep;65(9):1108-15. doi: 10.1111/j.1398-9995.2009.02317.x. Epub 2010 Feb 1.
Asthma treatment costs are substantial, the largest proportion being incurred by medications. Combination therapy with inhaled corticosteroids (ICS) and long-acting beta(2)-agonists (LABA) is recommended in patients not adequately controlled by ICS alone. Aim of this study was to compare costs and health outcomes of a fixed ICS-LABA combination of beclomethasone dipropionate (BDP) and formoterol fumarate (FF) vs the same drugs delivered via separate inhalers in Germany.
A cost-minimization analysis, a cost-effectiveness analysis, as well as a threshold analysis were undertaken. Efficacy results were obtained from a recent clinical trial. Cost inputs include medical costs, physician costs, and hospital admission costs. Medical costs, health outcomes, and treatment costs were also varied to assess their impact on results.
Beclomethasone dipropionate/FF fixed combination was less costly compared to BDP + FF delivered as separate inhalers, costs totaling euro 525 and euro 637, respectively, over a 24-week treatment period. The incremental cost-effectiveness ratio was euro-9.77 per additional day free of asthma symptoms. Equal cost-effectiveness ratios would still be obtained at a price of the fixed combination increased by 3.4-fold.
A cost-minimization analysis as well as a cost-effectiveness analysis for Germany based on different product price calculations show that BDP/FF fixed combination is superior to BDP + FF delivered via separate inhalers.
哮喘治疗费用相当可观,其中最大的一部分是药物费用。对于那些单独使用吸入皮质激素(ICS)不能充分控制病情的患者,推荐采用 ICS 与长效β2-激动剂(LABA)联合治疗。本研究旨在比较在德国使用丙酸倍氯米松(BDP)和富马酸福莫特罗(FF)固定剂量联合吸入器与使用分开的吸入器治疗哮喘的成本和健康结果。
进行了成本最小化分析、成本效益分析和阈值分析。疗效结果来自最近的一项临床试验。成本投入包括医疗费用、医生费用和住院费用。还对医疗成本、健康结果和治疗成本进行了变化,以评估其对结果的影响。
在 24 周的治疗期间,与 BDP + FF 分开使用相比,丙酸倍氯米松/FF 固定剂量联合使用的成本更低,总成本分别为 525 欧元和 637 欧元。增量成本效益比为每增加一天无哮喘症状的额外费用为 9.77 欧元。即使固定联合制剂的价格增加 3.4 倍,仍会得到相同的成本效益比。
基于不同产品价格计算的德国成本最小化分析和成本效益分析表明,BDP/FF 固定剂量联合使用优于 BDP + FF 分开使用。