Study objectives: To evaluate the
cost-effectiveness of inhaled fluticasone propionate (FP) in children
aged 12 to 47 months with asthma symptoms.
retrospective economic analysis conducted from the perspective of the
Danish health-care system, based on clinical data from a 12-week
Setting: Thirty-three outpatient centers in
Patients: Two hundred thirty-seven
children aged 12 to 47 months with documented history of recurrent
wheeze or asthma symptoms.
Interventions: Two dosages
of FP, 100 μg/d and 200 μg/d, and placebo administered in two
divided doses via a metered-dose inhaler and a Babyhaler (Glaxo
Wellcome; Middlesex, UK) spacer device.
Effectiveness in terms of asthma exacerbations, control of cough and
wheeze symptoms, symptom-free days, overall direct costs of asthma
management in Danish kroner at 1999 prices, and mean and incremental
Results: FP, 200 μg/d,
was significantly more effective than placebo treatment in terms of the
proportion of exacerbation-free patients (73.7% vs 59.8%;
p = 0.025) and patients experiencing a ≥ 25% improvement in cough
symptoms (57.9% vs 39.0%; p = 0.018). The costs per
exacerbation-free patient, per patient with a ≥ 25% improvement in
cough and wheeze symptoms from baseline, and per symptom-free day were
lower in the FP groups than in the placebo group. The incremental
cost-effectiveness ratios for these end points indicated that the
additional benefits of FP, 200 μg/d, were achieved at a lower overall
cost compared with placebo treatment.
From the perspective of the Danish health-care system, FP, 100 μg
bid, administered via the Babyhaler inhalation device was
cost-effective relative to standard therapy with bronchodilators