Cost-effectiveness of budesonide-formoterol in maintenance therapy of asthma patients

Abstract

Objective: to perform a cost-effectiveness analysis of asthma treatment with budesonide/formoterol against other treatment options used at Mexico’s National Institute for Respiratory Diseases. Methods: A complete economic evaluation of cost-effectiveness from a public health perspective, comparing the use of budesonide/formoterol as maintenance therapy with fluticasone/vilanterol in 103 female asthma patients managed at INER between 2015 and 2021. Results: Average cost per patient was $743.23 USD, $733.36 USD for budesonide/formoterol and $767.24 USD for fluticasone/vilanterol. Pharmacological treatment represented over 70% of management costs for both groups, followed by follow-up visits and exacerbation management costs. LABA-ICS represented the highest proportion of pharmacologic management costs with a statistically significant difference amongst groups with an incremental cost of $80.17 USD for the fluticasone/vilanterol group. The budesonide/formoterol group showed an ICER of $613.31 USD for reducing the proportion of patients experiencing exacerbations during follow-up. Considering the willingness to pay threshold based on one GDP per capita ($10,902.98 USD in 2022), budesonide/formoterol represented a very cost-effective option. Conclusions: The ICER favored budesonide/formoterol over fluticasone/vilanterol in terms of cost-effectiveness. A 5.5% reduction in patient exacerbations indicated decreased disease burden. While not statistically significant, fewer exacerbations per patient might still cut costs by lowering emergency visits and hospitalizations.