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Cost-effectiveness analysis of budesonide/formoterol for maintenance and reliever asthma therapy in Denmark - based on five randomised controlled trials.
Asthma is a common chronic disease in Denmark and affects approximately 6 per cent of the adult population. Furthermore, asthma has a vast impact on healthcare resources and costs, and direct and indirect costs have previously been estimated at EUR 147.8 million and EUR 114 million respectively.
COWI carried out a cost-effectiveness analysis commissioned by AstraZeneca Denmark. Their Symbicort Maintenance and Reliever Therapy (Symbicort SMART®) is an effective asthma-therapy that combines inhaled corticosteroid (ICS) budesonide and long-acting β2-agonist (LABA) formoterol in one inhaler. It is used as both maintenance and reliever therapy to improve overall asthma control by reducing symptoms as well as exacerbations.
The aim was to investigate whether budesonide/formoterol for maintenance and reliever therapy is a cost-effective treatment option in a Danish setting, compared to a range of other relevant treatment options in Denmark.
Data collectionA thorough review of all relevant Symbicort SMART® clinical studies was performed. Five randomised controlled trials met the predefined criteria and were included in the cost-effectiveness analyses. The endpoint was the rate of severe exacerbations per patient. Resource use data was collected through the clinical trials. Furthermore, Danish unit costs were applied in the analyses.
Cost-effectivenessThe cost-effectiveness analyses showed that the significant reduction of severe asthma exacerbations observed in the clinical studies was obtained at lower costs or small incremental costs compared with the treatment alternatives. When looking at the societal perspective, where total direct and indirect costs were included, budesonide/formoterol as maintenance and reliever therapy was a dominant treatment option in four out of five randomised controlled trials, demonstrating both fewer instances of exacerbations and lower costs. In one of the clinical trials, the budesonide/formoterol treatment option was a more effective, but also marginally more expensive, therapy.
ConclusionOverall, the results indicate that budesonide/formoterol as maintenance and reliever therapy is a cost-effective treatment option in a Danish setting.
The results of the cost-effectiveness analysis were published in The Clinical Respiratory Journal in the spring of 2009. The article was the first to investigate the cost-effectiveness of the budesonide/formoterol maintenance and reliever treatment option based on all available relevant clinical studies.
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(Cost-effectiveness of budesonide/formoterol for maintenance and reliever asthma therapy in Denmark – Cost-effectiveness analysis based on five randomised controlled trials. Wickstrøm J, Dam N, Malmberg I, Hansen BB, Lange P. The Clinical Respiratory Journal;3(3):169-180. © 2009 Blackwell Publishing Ltd.)