Cost-effectiveness of including salmeterol in asthma therapy in a primary care setting in Japan.

To discuss and estimate the clinical and economic benefits obtained during combination therapy with inhaled corticosteroids (ICS) plus salmeterol (SLM) for Japanese patients with asthma on the basis of the Global Initiative for Asthma (GINA) Guidelines. Fifty-four cases aged>16 years with either moderate persistent asthma (step 3) or severe persistent asthma (step 4) were assessed in a retrospective survey. Participants must have been a patient at the author's clinic continuously from June 2001 and been users of SLM for more than one year. Signed informed consent was obtained. Both clinical and economic components of SLM use in asthma therapy over the past two years were evaluated. Cost analyses revealed that SLM use significantly reduced medical costs of leukotriene receptor antagonist and short-acting inhaled beta(2)-agonists. Moreover, clinical outcomes (e.g. symptom-free day) were significantly improved after initiation of SLM. Sensitivity analyses confirmed that use of SLM is cost-effective. Combination therapy with inhaled corticosteroids and SLM on the basis of GINA guidelines appears to be efficacious and cost effective for the treatment of moderate or severe persistent asthma in Japanese patients.