Gene Colice, Richard J Martin, Elliot Israel, Nicolas Roche, Neil Barnes, Anne Burden, Peter Polos, Paul Dorinsky, Elizabeth V Hillyer, Amanda J Lee, Alison Chisholm, Julie von Ziegenweidt, Francesca Barion, David Price
Washington Hospital Center and George Washington University School of Medicine, Washington, DC, USA.
The Journal of allergy and clinical immunology 2013 JulCharacteristics of inhaled corticosteroids (ICSs) differ, but data comparing the real-life effectiveness of various ICSs for asthma are lacking. We sought to compare real-life asthma outcomes and costs of extrafine hydrofluoroalkane (HFA)-beclomethasone and fluticasone administered through a pressurized metered-dose inhaler. This retrospective matched cohort study examined database markers of asthma control from a large US longitudinal health care claims database over 1 baseline and 1 outcome year for 10,312 patients with asthma aged 12 to 80 years receiving their first ICS as HFA-beclomethasone or fluticasone and matched on baseline demographic characteristics and asthma severity. Patients started on HFA-beclomethasone had significantly higher odds (adjusted odds ratio, 1.19; 95% CI; 1.08-1.31) of achieving overall control (risk and impairment), which was defined as no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory tract infection and less than 2 puffs per day of short-acting β-agonist; they also experienced a lower rate of respiratory-related hospitalizations or referrals (adjusted rate ratio, 0.82; 95% CI, 0.73-0.93) than patients started on fluticasone. Other database outcome measures were similar in the 2 cohorts. Prescribed HFA-beclomethasone doses were lower (P < .001) than fluticasone doses (median, 320 μg/d [interquartile range, 160-320 μg/d] vs 440 μg/d [interquartile range, 176-440 μg/d]). Adjusted respiratory-related health care costs were significantly lower for HFA-beclomethasone than fluticasone (mean, $1869 [95% CI, $1727-$2032] vs $2259 [95% CI, $2111-$2404]), representing a mean annual savings of $390 (95% CI, $165-$620) per patient prescribed HFA-beclomethasone rather than fluticasone. Asthma treatment outcomes were similar or better with HFA-beclomethasone prescribed at significantly lower doses and with lower costs than fluticasone. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
Gene Colice, Richard J Martin, Elliot Israel, Nicolas Roche, Neil Barnes, Anne Burden, Peter Polos, Paul Dorinsky, Elizabeth V Hillyer, Amanda J Lee, Alison Chisholm, Julie von Ziegenweidt, Francesca Barion, David Price. Asthma outcomes and costs of therapy with extrafine beclomethasone and fluticasone. The Journal of allergy and clinical immunology. 2013 Jul;132(1):45-54
PMID: 23591272
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