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Resource utilization in asthma: combined fluticasone propionate/salmeterol compared with inhaled corticosteroids.
Curr Med Res Opin. 2007 Feb; 23(2):427-34.CM

Abstract

BACKGROUND

Asthma management guidelines recommend low-dose inhaled corticosteroids (ICS) for initial treatment of mild persistent asthma. Instead, data from primary care practice show that many patients start on combination therapy with fluticasone propionate/salmeterol (FPS) for mild asthma. The consequences of this variance from guideline recommendations are not well described.

OBJECTIVE

Compare healthcare utilization and asthma-related outcomes for patients with mild asthma who began treatment with FPS or ICS alone. Design and data source: A retrospective analysis of asthma-related insurance claims. Patients initially treated with FPS or ICS were identified from an administrative health insurance claims database and followed for 1 year. Analyses of resource utilization 6 months before therapy initiation identified patients with mild asthma. Propensity score matching managed between-group differences in clinical characteristics and controlled for selection bias.

OUTCOME MEASURES

Resource use was determined for asthma-related outpatient visits, emergency room services, hospitalizations, and medications.

RESULTS

Demographic characteristics and comorbidities were similar for each group (FPS, n = 1888; ICS, n = 1888). During the 12-month follow-up period, total asthma-related costs were significantly higher for FPS versus ICS (1206 vs. 804 dollars; p < 0.0001), owing primarily to significantly higher drug costs for FPS versus ICS (677 vs. 357 dollars; p < 0.0001). The percentage of patients experiencing an exacerbation (14.0% FPS, 13.5% ICS) and the average number of exacerbations in each group (0.175 FPS, 0.164 ICS) were similar.

CONCLUSIONS

Healthcare costs were found to be lower in patients receiving ICS than in those receiving FPS, with similar health outcomes in both groups. Study limitations included the use of claims data and a proxy definition of asthma severity, and potential confounding by unobserved factors.

Authors+Show Affiliations

Analytic Solutions, LLC, New York, NY 10012, USA. Howard@analytic-consulting.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17288696

Citation

Friedman, Howard S., and Barbara P. Yawn. "Resource Utilization in Asthma: Combined Fluticasone Propionate/salmeterol Compared With Inhaled Corticosteroids." Current Medical Research and Opinion, vol. 23, no. 2, 2007, pp. 427-34.
Friedman HS, Yawn BP. Resource utilization in asthma: combined fluticasone propionate/salmeterol compared with inhaled corticosteroids. Curr Med Res Opin. 2007;23(2):427-34.
Friedman, H. S., & Yawn, B. P. (2007). Resource utilization in asthma: combined fluticasone propionate/salmeterol compared with inhaled corticosteroids. Current Medical Research and Opinion, 23(2), 427-34.
Friedman HS, Yawn BP. Resource Utilization in Asthma: Combined Fluticasone Propionate/salmeterol Compared With Inhaled Corticosteroids. Curr Med Res Opin. 2007;23(2):427-34. PubMed PMID: 17288696.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resource utilization in asthma: combined fluticasone propionate/salmeterol compared with inhaled corticosteroids. AU - Friedman,Howard S, AU - Yawn,Barbara P, PY - 2007/2/10/pubmed PY - 2007/3/16/medline PY - 2007/2/10/entrez SP - 427 EP - 34 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 23 IS - 2 N2 - BACKGROUND: Asthma management guidelines recommend low-dose inhaled corticosteroids (ICS) for initial treatment of mild persistent asthma. Instead, data from primary care practice show that many patients start on combination therapy with fluticasone propionate/salmeterol (FPS) for mild asthma. The consequences of this variance from guideline recommendations are not well described. OBJECTIVE: Compare healthcare utilization and asthma-related outcomes for patients with mild asthma who began treatment with FPS or ICS alone. Design and data source: A retrospective analysis of asthma-related insurance claims. Patients initially treated with FPS or ICS were identified from an administrative health insurance claims database and followed for 1 year. Analyses of resource utilization 6 months before therapy initiation identified patients with mild asthma. Propensity score matching managed between-group differences in clinical characteristics and controlled for selection bias. OUTCOME MEASURES: Resource use was determined for asthma-related outpatient visits, emergency room services, hospitalizations, and medications. RESULTS: Demographic characteristics and comorbidities were similar for each group (FPS, n = 1888; ICS, n = 1888). During the 12-month follow-up period, total asthma-related costs were significantly higher for FPS versus ICS (1206 vs. 804 dollars; p < 0.0001), owing primarily to significantly higher drug costs for FPS versus ICS (677 vs. 357 dollars; p < 0.0001). The percentage of patients experiencing an exacerbation (14.0% FPS, 13.5% ICS) and the average number of exacerbations in each group (0.175 FPS, 0.164 ICS) were similar. CONCLUSIONS: Healthcare costs were found to be lower in patients receiving ICS than in those receiving FPS, with similar health outcomes in both groups. Study limitations included the use of claims data and a proxy definition of asthma severity, and potential confounding by unobserved factors. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/17288696/Resource_utilization_in_asthma:_combined_fluticasone_propionate/salmeterol_compared_with_inhaled_corticosteroids_ L2 - https://www.tandfonline.com/doi/full/10.1185/030079906X167417 DB - PRIME DP - Unbound Medicine ER -