Objective: The aim of the present study was to determine the cost-utility of single inhaler combination inhaled corticosteroid and a long-acting β2-agonist (ICS/LABAs) as both maintenance and reliever (SMART) compared with a step-up maintenance treatment with a fixed medium to high dose of ICS combined with LABA and a short-acting β2-agonist (SABA) as reliever (ICS-LABA maintenance plus SABA) among patients aged 12 years or more with poorly controlled asthma in Colombia.
Methods: A Markov-type model was developed to estimate the costs and health outcomes of a simulated cohort of patients aged 12 years or more with uncontrolled asthma treated for 12 months. The main effectiveness data were obtained from a recent meta-analysis. The main outcome was the variable ''quality-adjusted life-years'' (QALYs).
Results: The base-case analysis showed that the budesonide/formoterol (BUD/FORM) SMART strategy was associated with lower overall treatment costs (US $3,062.37 vs. $4,462.02 average cost per patient over 12 months) and the greatest gain in QALYs (0.8511 vs. 0.8258 QALYs on average per patient over 12 months) compared with ICS-LABA maintenance plus SABA at step 4, thus leading to dominance.
Conclusions: In patients aged 12 years or more with uncontrolled asthma at GINA step 3 or 4, the BUD/FORM SMART strategy at either step 3 or 4 is cost-effective compared with the ICS-LABA maintenance plus SABA at step 4 strategy, because it shows a greater gain in QALYs at lower total treatment costs.
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| http://dx.doi.org/10.1080/02770903.2024.2410424 | DOI Listing |
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Comparative analysis of real-world data on the efficacy and safety of and adherence to ICS/LABA combinations in asthma management.
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Department of Pulmonary, Allergy, and Critical Care Medicine, Chungnam National University School of Medicine, Daejeon, South Korea.
Background: Choosing effective devices (inhaled corticosteroid [ICS]-long-acting β2 agonist [LABA] combination inhalers) as maintenance treatment is critical for managing patients with asthma. We aimed to compare ICS/LABA combination efficacy, safety, and adherence across inhaler types and components in patients newly diagnosed with asthma.
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Ankara University School of Medicine, Department of Chest Disease, Division of Immunology and Allergy, Ankara, Turkey.
Current guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians' preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics.
View Article and Find Full Text PDFClinical Remission in Patients With Biologic-Naïve Asthma: A Multicenter Study in Japan.
J Allergy Clin Immunol Pract
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Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan.
Background: Clinical remission (CR) is a new realistic management goal for patients with asthma, regardless of the disease severity.
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A cost-utility analysis of single maintenance and reliever (SMART) therapy as compared to step 3 fixed-dose therapy in patients aged 12 years or more with uncontrolled asthma.
Pediatr Pulmonol
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Division of Pediatrics, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Objectives: A significant percentage of patients with asthma appear to benefit from the addition of long-acting β2-agonists (LABAs) to ICS to achieve better control of their disease. The aim of the present study was to determine the cost-utility of single inhaler combination inhaled ICS/LABAs as both maintenance and reliever (SMART) versus remaining at the same treatment step with fixed-dose ICS-LABA maintenance with a short-acting β2-agonist (SABA) as reliever in patients aged 12 years or more with uncontrolled asthma.
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Characteristics of Patients with COPD Initiating Budesonide/Glycopyrronium/Formoterol or Other Triple Therapies in Japan: A Real-World Healthcare Claims Database Study (MITOS-AURA).
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Respiratory Evidence Strategy, BioPharmaceuticals Medical, AstraZeneca, Academy House, 136 Hills Road, Cambridge, CB2 8PA, UK.
Article Synopsis
- In Japan, there are different inhaler combinations for treating chronic obstructive pulmonary disease (COPD), including single-inhaler and multiple-inhaler triple therapies, but there is limited information about how patients are actually treated in real-life scenarios.
- This study reviewed data from COPD patients in Japan from May 2018 to December 2021, categorizing them into four groups based on the triple therapy they started, including early adopters of a specific therapy and users of other available combinations.
- The findings revealed that a high percentage of patients had asthma as a comorbidity, and around 14% to 18% experienced moderate to severe exacerbations in the year before starting treatment, indicating significant healthcare resource utilization
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