Budget Impact of Anti-Inflammatory Reliever Therapy with Budesonide-Formoterol Combination in the Treatment of Mild Asthma in Honduras
Author(s)
Ordoñez J1, Buitrago R2, Sosa Ferrari S3
1True Consulting, MEDELLIN, ANT, Colombia, 2AstraZeneca CAC, San José, Costa Rica, 3Hospital del Tórax, Tegucigalpa, FM, Honduras
OBJECTIVES: Asthma is a heterogeneous disease characterized by airway inflammation. Daily inhaled corticosteroid (ICS) plus short-acting beta-agonist (SABA) as a reliever is the standard of care (SoC) in Honduras for mild asthma. Anti-inflammatory reliever (AIR) therapy with budesonide–formoterol (Bud-Form) as needed is at least as effective as ICS monotherapy plus SABA as a reliever in reducing oral corticosteroid use, emergency room (ER) visits and hospitalizations; however, in Honduras, the information on the budget impact of the efficacy of AIR in patients with mild asthma is unknown.
METHODS: We performed a model comparing Bud-Form as needed vs. daily ICS plus SABA as reliever therapy (SoC). Data about treatment-related outcomes are from published clinical trials and exacerbations medicines, ER visits, and hospitalizations from an advisory board with local pulmonologists. The first-year market share for AIR is 2%, 10% in the second year, and 15% in the third year; was assumed. Costs are in USD. Costs per inhaler: Bud-Form 160/4,5µg, $20.50; beclomethasone 100µg, $2.37; fluticasone propionate 250µg, $16.48; budesonide 200µg, $6.55; and salbutamol 100µg, $2.15. All inhalers have 120 inhalations, except beclomethasone and salbutamol, which have 200. All ICS need two inhalations/day; the mean number of inhalations: Bud-Form as needed=0.52 inhalations/day and salbutamol=0.98 inhalations/day. Compliance is 100% for all treatments. A population of 128,326 patients in the first year, 138,218 second year, and 148,325 third year was assumed. Relapsing average costs are $128 for an ER visit and $248 for a hospitalization.
RESULTS: Bud-Form, as needed, saves $22,768 the first year (-0.4%), $122,704 a second year (-2.1%), and $197,514 the third year (-3.2%). The savings are directly proportional to the market share of patients using AIR therapy.
CONCLUSIONS: In Honduras, the total budget impact over three years due to the introduction of Bud-Form as needed was $342,987, less expensive than SoC in patients with mild asthma.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
EE73
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Thresholds & Opportunity Cost
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)