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Fluticasone Is Associated with Lower Asthma‐Related Costs than Leukotriene Modifiers in a Real‐World Analysis
Author(s) -
Armstrong Edward P.,
Malone Daniel C.
Publication year - 2002
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.22.13.1117.33515
Subject(s) - fluticasone propionate , fluticasone , medicine , asthma , montelukast , leukotriene , zafirlukast , leukotriene e4 , medical prescription , gastroenterology , pharmacology
Study Objective. To compare the impact of fluticasone propionate versus three leukotriene modifiers—montelukast, zafirlukast, and zileuton—on the cost of asthma within a managed care organization. Design. Retrospective quasi‐experimental comparison. Setting. Managed care organization with approximately 350,000 enrollees. Patients. Three hundred forty‐seven patients with asthma who received at least two prescriptions for either fluticasone or a leukotriene modifier. Patients receiving both fluticasone and a leukotriene modifier were excluded. Measurements and Main Results. Multivariate analysis was used to compare total asthma‐related costs between treatment groups. A significant difference in total asthma‐related costs was found between patients receiving fluticasone (adjusted mean cost $511) compared with those receiving a leukotriene modifier ($1092; p=0.0001). Other significant predictors of postindex asthma‐related costs were pre‐index asthma‐related costs, a severity adjustment score, and the diagnosis of chronic obstructive pulmonary disease. Patients taking a leukotriene modifier obtained more short‐acting β‐agonists than patients receiving fluticasone (6.49 ± 4.05 vs 4.30 ± 3.41, p<0.0001). A survival analysis of time to receive any additional controller therapy revealed that patients receiving fluticasone were significantly less likely to receive another controller than were those receiving a leukotriene modifier (p=0.0014). Conclusion. These results suggest that fluticasone is associated with lower asthma‐related costs than leukotriene modifiers. (Pharmacotherapy 2002;22(9):1117–1123)