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 Panama 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 Panama, the information on the budget impact of the efficacy of AIR in patients with mild asthma is unknown.

METHODS: 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. The currency was American dollars (USD). Costs per inhaler: Bud-Form 160/4.5µg, $29.14; beclomethasone 100µg, $2.00; fluticasone propionate 250µg, $39.39; budesonide 200µg, $9.21; and salbutamol 100µg, $.,00. 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. All treatments have 100% of adherence. A population of 31,063 patients in the first year, 36,130 second year, and 40,707 third year was assumed. Relapsing average costs are $655 for an ER visit and $1,263 for a hospitalization.

RESULTS: Bud-Form, as needed, saves $23,313 first year (-0.9%), $133,260 second year (-4.4%), and $225,214 third year (-6.7%). The savings are directly proportional to the market share of patients using AIR therapy.

CONCLUSIONS: In Panama, the total budget impact over three years due to the introduction of Bud-Form as needed was $381,787, less expensive than SoC in patients with mild asthma.