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Health-care utilization and costs with fluticasone propionate and fluticasone propionate/salmeterol in asthma patients at risk for exacerbations.
Allergy Asthma Proc. 2014 Jan-Feb; 35(1):54-62.AA

Abstract

Although studies have established that adding long-acting beta agonists (LABA) to inhaled corticosteroid (ICS) monotherapy among patients with inadequately controlled asthma is associated with better outcomes than increasing ICS dosage, outcomes with ICS versus fixed-dose ICS/LABA combination among patients with recent asthma exacerbation or frequent use of rescue medication are unavailable. This study was designed to compare health-care utilization/costs among patients with recent asthma exacerbation or frequent rescue medication use who received fluticasone propionate (FP) alone versus fixed-dose FP/salmeterol combination (FSC). A retrospective cohort study was conducted using a large health insurance data set. Patients with one or more claims with asthma diagnosis, two or more prescriptions for FSC (250/50- or 100/50-mg formulations) or FP (220- or 110-mg formulations), and one or more asthma exacerbations or five or more short-acting beta agonist (SABA) prescriptions within 1 year before initial receipt of study medications were included. Health-care utilization/costs and controller therapy compliance were compared for patients receiving FSC versus FP using multivariate regression analysis controlling for FP dose and baseline characteristics. A total of 7779 patients met inclusion criteria (5769, FSC, and 2010, FP) with comparable mean follow-up (FSC, 685 days; FP, 670 days; p = 0.151). Controlling for FP dosage and baseline characteristics, FSC patients had lower risks of asthma-related exacerbations, fewer SABAs and systemic corticosteroids, higher costs of asthma medications and total asthma-related health care, and lower total asthma-related health-care costs excluding study medication cost. In asthma patients with recent exacerbation or frequent SABA use, receipt of FSC reduced asthma-related exacerbation risks and rescue medication use versus receipt of FP.

Authors+Show Affiliations

Policy Analysis, Inc., Brookline, Massachusetts, and 2GlaxoSmithKline, Research Triangle Park, North Carolina, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24433597

Citation

Hagiwara, May, et al. "Health-care Utilization and Costs With Fluticasone Propionate and Fluticasone Propionate/salmeterol in Asthma Patients at Risk for Exacerbations." Allergy and Asthma Proceedings, vol. 35, no. 1, 2014, pp. 54-62.
Hagiwara M, Delea TE, Stanford RH. Health-care utilization and costs with fluticasone propionate and fluticasone propionate/salmeterol in asthma patients at risk for exacerbations. Allergy Asthma Proc. 2014;35(1):54-62.
Hagiwara, M., Delea, T. E., & Stanford, R. H. (2014). Health-care utilization and costs with fluticasone propionate and fluticasone propionate/salmeterol in asthma patients at risk for exacerbations. Allergy and Asthma Proceedings, 35(1), 54-62. https://doi.org/10.2500/aap.2014.35.3720
Hagiwara M, Delea TE, Stanford RH. Health-care Utilization and Costs With Fluticasone Propionate and Fluticasone Propionate/salmeterol in Asthma Patients at Risk for Exacerbations. Allergy Asthma Proc. 2014 Jan-Feb;35(1):54-62. PubMed PMID: 24433597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health-care utilization and costs with fluticasone propionate and fluticasone propionate/salmeterol in asthma patients at risk for exacerbations. AU - Hagiwara,May, AU - Delea,Thomas E, AU - Stanford,Richard H, PY - 2014/1/18/entrez PY - 2014/1/18/pubmed PY - 2014/9/12/medline SP - 54 EP - 62 JF - Allergy and asthma proceedings JO - Allergy Asthma Proc VL - 35 IS - 1 N2 - Although studies have established that adding long-acting beta agonists (LABA) to inhaled corticosteroid (ICS) monotherapy among patients with inadequately controlled asthma is associated with better outcomes than increasing ICS dosage, outcomes with ICS versus fixed-dose ICS/LABA combination among patients with recent asthma exacerbation or frequent use of rescue medication are unavailable. This study was designed to compare health-care utilization/costs among patients with recent asthma exacerbation or frequent rescue medication use who received fluticasone propionate (FP) alone versus fixed-dose FP/salmeterol combination (FSC). A retrospective cohort study was conducted using a large health insurance data set. Patients with one or more claims with asthma diagnosis, two or more prescriptions for FSC (250/50- or 100/50-mg formulations) or FP (220- or 110-mg formulations), and one or more asthma exacerbations or five or more short-acting beta agonist (SABA) prescriptions within 1 year before initial receipt of study medications were included. Health-care utilization/costs and controller therapy compliance were compared for patients receiving FSC versus FP using multivariate regression analysis controlling for FP dose and baseline characteristics. A total of 7779 patients met inclusion criteria (5769, FSC, and 2010, FP) with comparable mean follow-up (FSC, 685 days; FP, 670 days; p = 0.151). Controlling for FP dosage and baseline characteristics, FSC patients had lower risks of asthma-related exacerbations, fewer SABAs and systemic corticosteroids, higher costs of asthma medications and total asthma-related health care, and lower total asthma-related health-care costs excluding study medication cost. In asthma patients with recent exacerbation or frequent SABA use, receipt of FSC reduced asthma-related exacerbation risks and rescue medication use versus receipt of FP. SN - 1539-6304 UR - https://www.unboundmedicine.com/medline/citation/24433597/Health_care_utilization_and_costs_with_fluticasone_propionate_and_fluticasone_propionate/salmeterol_in_asthma_patients_at_risk_for_exacerbations_ L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=1088-5412&volume=35&issue=1&spage=54&aulast=Hagiwara DB - PRIME DP - Unbound Medicine ER -