Evaluating the cost effectiveness of asthma inhaler systems: An observational study of patients in General Practice in the UK

Abstract

This observational database study estimates the comparative cost effectiveness of salbutamol when delivered via a pressurised metered-dose inhaler (pMDI) or breath-actuated metered-dose inhaler (BAI) in patients with mild intermittent asthma who have changed from a pMDI to either a different pMDI or a BAI. Salbutamol use in the BAI cohort in the 12 months following the index event was 42% (p<0.001) of that in the pMDI cohort. Patients in the BAI cohort were more likely to require steroids (20 versus 16%, not significant) and had 10% fewer asthma consultations (1.01 vs. 1.11, p<0.001) in the 12-month period following the index event. To control for potentially confounding differences in the patient cohorts, a regression analysis was undertaken to identify the impact of individual elements in the analysis. The results of this controlled analysis identified that despite controlling for such factors, significantly less (p<0.001) salbutamol was still consumed in the BAI cohort. This result would seem to emphasise the enhanced efficiency and reduced wastage associated with BAI in real-world clinical practice. However, the cost analysis found that BAI would require a 27.5% reduction in unit price (i.e. from the current weighted unit price of £6.25 to £4.23) in order to result in the same unit prescription costs as pMDI. © 2007 Informa UK Ltd.