Cost Effectiveness of Fluticasone Propionate Plus Salmeterol Versus Fluticasone Propionate Plus Montelukast in the Treatment of Persistent Asthma

Background: Asthma is a chronic disease, the two main components of which are inflammation and bronchoconstriction. Fluticasone propionate (FP) and salmeterol, a strategy that treats both main components of asthma, has been recently compared with FP plus montelukast in a randomised clinical trial. The present study reports economic evaluation of these two strategies. Objective: To determine the relative cost effectiveness when persistent asthma is treated with FP/salmeterol 100/50mug twice daily administered via a single Diskus(R) inhaler device versus treatment with FP 100mug twice daily via a Diskus(R) inhaler plus oral montelukast 10mg once daily. Study design: A cost-effectiveness analysis was performed by applying cost unit data to resource utilisation data collected prospectively during a US randomised, double-blind, 12-week trial of FP/salmeterol Patients and methods: Efficacy measurements in this analysis included improvement in forced expiratory volume in 1 second (FEV1) and symptom-free days. Direct costs included those related to study drugs, emergency room department visits, unscheduled physician visits, treatment of drug-related adverse events (oral candidiasis), and rescue medication (salbutamol [albuterol]). The study assumed a US third-party payer Results: Treatment with FP/salmeterol resulted in a significantly higher proportion (p Conclusion: From a US third-party payer