Cost-effectiveness of Salmeterol/Fluticasone Combination Therapy vs. Fluticasone Propionate in Japanese Asthmatic Patients

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  • TOHDA Yuji
    Department of Respiratory and Allergology, Kinki University, School of Medicine NPO Japan Asthma and COPD Forum (JASCOM), c/o PRAP Japan Inc.
  • NISHIMA Sankei
    National Hospital Organization, Fukuoka National Hospital NPO Japan Asthma and COPD Forum (JASCOM), c/o PRAP Japan Inc.
  • ARAKAWA Ichiro
    Unit of Social and Administrative Pharmacy Sciences, College of Pharmacy, Nihon University
  • SHIRAGAMI Makoto
    Unit of Social and Administrative Pharmacy Sciences, College of Pharmacy, Nihon University
  • MIYAMOTO Terumasa
    Japan Clinical Allergy Research Institute NPO Japan Asthma and COPD Forum (JASCOM), c/o PRAP Japan Inc.

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Other Title
  • 喘息の治療と管理におけるサルメテロール／フルチカゾン製剤の費用対効果―プロピオン酸フルチカゾンとの比較検討―
  • ゼンソク ノ チリョウ ト カンリ ニ オケル サルメテロール フルチカゾン セイザイ ノ ヒヨウ タイ コウカ プロピオンサン フルチカゾン ト ノ ヒカク ケントウ

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Abstract

  We commenced to estimate the economic impact of salmeterol/fluticasone combination (SFC) therapy compared to fluticasone propionate (FP) therapy for asthma control in Japanese patients. A Markov model with five health states, developed by Price in 2002, was used. 1-week transition probabilities among status of asthma management were obtained from literature and epidemiological data from public data base. Direct cost for treatment was estimated from Japan medical fee schedule. Cost and effectiveness were not discounted due to 12-week simulation by the model. Univariate sensitivity analyses were undertaken to examine the main variables affecting cost-effectiveness. Probabilistic analysis was also undertaken to discuss statistical argument and to provide information for decision-making. In this analysis, the model was run over a 12-week period of time using transition probabilities. The results showed that treatment with SFC resulted in a higher proportion of totally controlled weeks per patient than treatment with FP (65.0 vs. 49.5%; incremental effectiveness by 15.5%), and lower mean direct asthma management costs (¥168 702 vs. ¥227 820). Probabilistic sensitivity analysis, conducted to assess robustness of the above base case result, showed that in the 95% of cases SFC was dominant (more effective and less costly) to FP. It suggested that SFC will be the most cost-effective therapy for asthma control. It would, however, be required to further evaluate cost-effectiveness of SFC in long-term observation.<br>

Journal

  • YAKUGAKU ZASSHI

    YAKUGAKU ZASSHI 130 (4), 593-603, 2010

    The Pharmaceutical Society of Japan

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