COMPARATIVE COST-MINIMIZATION AND BUDGET-IMPACT ANALYSIS OF FIXED-DOSE INHALED CORTICOSTEROID / LONG-ACTING BETAAGONIST COMBINATIONS IN THE TREATMENT OF ASTHMA
Abstract
Comparative pharmacoeconomic analysis of fixed-dose combinations (FDC) vilanterol / fluticasone furoate vs budesonide / formoterol was needed to identify the preferable FDC for asthma management.
Study objective: to identify the preferable FDC of inhaled corticosteroid/ longacting beta agonist combinations (ICS/LABA) for the treatment of moderate or severe asthma in Russia. Materials and
Methods. Retrospective comparative pharmacoeconomic study; cost-minimization analysis and budget-impact analysis.
Results. The present analysis shows that the 12-month direct medical costs for the treatment of asthma using vilanterol / fluticasone furoate and budesonide / formoterol are 29,276 and 40,447 RUR per patient, respectively. The direct costs of treatment with vilanterol / fluticasone furoate are less than those for budesonide / formoterol by 28%. The annual health budget savings that result from replacing budesonide / formoterol by vilanterol / fluticasone furoate are 1,151,512,731 RUR per 100,000 patients.
Conclusion. The present results indicate that the vilanterol / fluticasone furoate FDC is preferable (more beneficial) as compared with the budesonide / formoterol FDC.
About the Authors
N. L. Pogudina
Independent Research Company «Smart Choice»
Russian Federation
Russian Federation
PhD,
Otkrytoe shosse, 23/6, Moscow, 107143
E. G. Kosolapov
Independent Research Company «Smart Choice»
Russian Federation
Otkrytoe shosse, 23/6, Moscow, 107143
Russian Federation
Otkrytoe shosse, 23/6, Moscow, 107143
F. S. Kochenkov
Independent Research Company «Smart Choice»
Russian Federation
Russian Federation
PhD,
Otkrytoe shosse, 23/6, Moscow, 107143
A. V. Karaulov
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Acad. RAS, Prof., MD, Head of the Department of Clinical Immunology and Allergology,
ul. Trubetskaya, 8, str. 2, Moscow, 119048
N. L. Bondarenko
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation;
Clinical Hospital № 85, FMBA of Russia
Russian Federation
Russian Federation
PhD, Associate Professor of the Department of Clinical Immunology and Allergology;
Chief Physician, Kashirskoe shosse, d. 13G, Moscow, 115230
D. V. Blinov
N. I. Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
PhD,
ul. Ostrovityanova, 1, Moscow, 117997
References
1. Global Strategy for Asthma Management and Prevention. 2017. URL: www.ginasthma.org. Accessed: 12.04.2017.
2. Bronchial asthma. Clinical guidelines. MOO Russian respiratory society, IMO Paediatric respiratory society [Bronkhial’naya astma. Klinicheskie rekomendatsii. MOO Rossiiskoe respiratornoe obshchestvo, MMO Pediatricheskoe respiratornoe obshchestvo (in Russian)]. 2016; 76 s.
3. Chuchalin A. G. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. International Journal of Chronic Obstructive Pulmonary Disease. 2014; 9: 963-974.
4. Zaitsev A. A. Bronkhial’naya astma u vzroslykh: klyuchevye voprosy diagnostiki i farmakoterapii. RMZh. 2015; 18: 1096-1100.
5. The Federal target program “Bronchial asthma” (2011-2015) [Federal’naya tselevaya programma «Bronkhial’naya astma» (2011-2015 gody) (in Russian)]. Moscow. 2009.
6. Revich B. A., Khar’kova T. L. Chem boleyut i ot chego gibnut rossiyane trudosposobnogo vozrasta. Demoskop Weekly. 2016; 691-692. URL: http://demoscope.ru/weekly/2016/0691/tema01.php. Accessed: 16.02.2017.
7. Yagudina R. I., Kulikov A. Yu., Ogorodova L. M., Demko I. V., Tolkushin A. G., Kobyakova O. S., Chuchalin A. G. FARMAKOEKONOMIKA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology. 2010; 3 (1): 40-46.
8. Accordini S., Bugiani M., Arossa W. et al. Poor control increases the economic cost of asthma. A multicentre population-based study. Int Arch Allergy Immunol. 2006; 141 (2): 189-198.
9. Nazarova E. V., Latysheva E. A. RAZh. 2015; 5: 82-89.
10. Nenasheva N. M. Prakticheskaya Pul’monologiya. 2016; 3: 3-10.
11. Relvar Of Ellipta. Instruction for medical use. State registry of Medicines [Relvar Ellipta. Instruktsiya po meditsinskomu primeneniyu. Gosudarstvennyi reestr Lekarstvennykh Sredstv (in Russian)]. URL: www.grls.rosminzdrav.ru. Accessed: 26.12.2016.
12. Svedsater H., Stynes G., Wex J. et al. Once-daily fluticasone furoate/vilanterol versus twice daily combination therapies in asthmamixed treatment comparisons of clinical efficacy. Asthma Res Pract. 2016; 8 (2): 4. DOI: 10.1186/s40733-015-0016-0.
13. Hozawa S., Terada M., Haruta Y., Hozawa M. Comparison of early effects of budesonide/formoterol maintenance and reliever therapy with fluticasone furoate/vilanterol for asthma patients requiring step-up from inhaled corticosteroid monotherapy. Pulm Pharmacol Ther. 2016; 37: 15-23.
14. National Asthma Handbook. Version 1.1. National Asthma Council Australia, Melbourne – 2015.
15. Pavord I. D., Jeffery P. K., Qiu Y. et al. Airway inflammation in patients with asthma with high-fixed or low-fixed plus as-needed budesonide/formoterol. J Allergy Clin Immunol. 2009; 123 (5): 1083-1089, 1089. e7.
16. Scicchitano R., Aalbers R., Ukena D. et al. Efficacy and safety of budesonide/ formoterol single inhaler therapy versus a higher dose of budesonide in moderate to severe asthma. Curr Med Res Opin. 2004; 20: 1403-1418.
17. Rabe K. F., Atienza T., Magyar P., Larsson P., Jorup C., Lalloo U. G. Effect of budesonide in combination with formoterol for reliever therapy in asthma exacerbations: a randomised controlled, double-blind study. Lancet. 2006; 368: 744.
18. Aubier M., Buhl R., Ekstrom T. et al. Comparison of two twicedaily doses of budesonide/formoterol maintenance and reliever therapy. Eur. Respir. J. 2010: 36: 524-530.
19. Demoly P., Louis R., Soes-Petersen U. et al. Budesonide/ formoterol maintenance and reliever therapy versus conventional best practice. Respir. Med. 2009; 103: 1623-1632.
20. Vogelmeier C., D’Urzo A., Pauwels R. et al. Budesonide/ formoterol maintenance and reliever therapy: an effective asthma treatment option? Eur. Respir. J. 2005; 26: 819-828.
21. Stallberg B., Naya I., Ekelund J. et al. Follow-up programme for patients using Symbicort® Turbuhaler® maintenance and reliever therapy in real-world clinical practice. Prim. Care Respir. J. 2013; 22. A11.
22. Ställberg B., Naya I., Ekelund J., Eckerwall G. Real-life use of budesonide/formoterol in clinical practice: a 12-month followup assessment in a multi-national study of asthma patients established on single-inhaler maintenance and reliever therapy. International J of Clinical Pharmacology and Therapeutics. 2015; 53 (6): 447-455.
23. Patel M., Pichler P., Pritchard A. at al. Efficacy and safety of maintenance and reliever combination budesonide–formoterol inhaler in patients with asthma at risk of severe exacerbations: a randomised controlled trial. Lancet Resp Med. 2013; 1 (1): 32-42.
24. O’Byrne P. M., Bisgaard H., Godard P. P. et al. Budesonide/ formoterol combination therapy as both maintenance and reliever medication in asthma. Am J Respir Crit Care Med. 2005; 171: 129-36.
25. Fassakhov R. S. Budesonid/formoterol v rezhime SMART v terapii bronkhial’noi astmy: ot vliyaniya na vospalenie do terapii fenotipov. RMZh. 2016; 16: 1059-1064.
26. Slack R. J., Barrett V. J., Morrison V. S. et al. In vitro pharmacological characterization of vilanterol, a novel long-acting β2-adrenoceptor agonist with 24-hour duration of action. J. Pharmacol. Exp. Ther. 2013; 344: 218-230.
27. Valotis A., Högger P. Human receptor kinetics and lung tissue retention of the enhanced-affinity glucocorticoid fluticasone furoate. Respiratory Research. 2007; 8: 54-62.
28. European Medicines Agency. Summary of product characteristics: Relvar Ellipta inhalation powder. 2013. URL: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002673/WC500157633.pdf. Accessed: 22.12.2016.
29. Romanovskikh A. G., Belotserkovskaya Yu. G., Styrt E. A. Klin. med. 2015; 93 (12): 38-43.
30. Hren R., Stynes G. Cost-Minimization and Budget-Impact Analysis of Fixed-Dose Combination Inhalers in Treatment of COPD in Slovenia. Value Health. 2014; 17 (7): A592. DOI: 10.1016/j.jval.2014.08.2032.
31. Hren R., Trkman M., Stynes G. Cost-Minimization and BudgetImpact Analysis of Fixed-Dose ICS/LABA Combination Inhalers in the Treatment of Asthma in Slovenia. Value Health. 2014; 17 (7): A592. DOI: 10.1016/j.jval.2014.08.2031.
Review
For citations:
Pogudina N.L., Kosolapov E.G., Kochenkov F.S., Karaulov A.V., Bondarenko N.L., Blinov D.V. COMPARATIVE COST-MINIMIZATION AND BUDGET-IMPACT ANALYSIS OF FIXED-DOSE INHALED CORTICOSTEROID / LONG-ACTING BETAAGONIST COMBINATIONS IN THE TREATMENT OF ASTHMA. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2017;10(2):12-21. (In Russ.) https://doi.org/10.17749/2070-4909.2017.10.2.012-021
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