montelukast, in a population of pediatric patients with mild-to-moderate persistent asthma

METHODS. This study extracted data from the PACT study, a randomized controlled, double-blind, multicenter trial that studied treatment regimens in children with mildto-moderate persistent asthma. Both effectiveness and cost measures were used to determine a cost-effectiveness analysis of the 2 controller medications: fluticasone (100 g twice daily) and montelukast (5 mg daily), given for 48 weeks. Effectiveness measures included (1) asthma-control days (ACDs), (2) improvement in forced expiratory volume in 1 second (FEV1), and (3) the number of exacerbations avoided. Cost measures were taken from (1) direct costs from a third-party payer’s perspective, including the sum of costs from asthmarelated medication, emergency department visits, and regular physician’s office visits, and (2) societal costs, which were the direct costs plus productivity losses from asthma-related missed school or work. Costeffectiveness analysis was then used to compare the effectiveness of the different treatments relative to their costs. Cost-effectiveness analysis was also performed for subgroups on the basis of the phenotypic factors of exhaled nitric oxide (eNO) and the provocative concentration that causes a 20% decrease (PC20) in the forced expiratory volume in 1 second (FEV1).