Costs associated with common dual-controller therapies for treating asthma in several managed care populations.

OBJECTIVE To present results of 2 studies assessing the impact of 3 commonly prescribed dual-controller regimens on the cost of treating asthma in several managed care populations. DATA SOURCES Two previously published cross-sectional and longitudinal retrospective studies of patients aged 12-65 years with asthma, in selected managed care plans, who were taking an inhaled corticosteroid (ICS) and were prescribed an index prescription for salmeterol or a leukotriene modifier. CONCLUSIONS The cross-sectional study showed that different drug regimens were associated with measurable differences in outcome when both drug costs and use of medical services are taken into account. This stimulated a more rigorous follow-up study controlling for asthma severity by using preindex cost and use measures. The 12-month risk-adjusted total cost for the fluticasone propionate and salmeterol group was the lowest at 975 dollars, followed by 1,089 dollars and 1,268 dollars for the ICS and salmeterol and the ICS and leukotriene modifier groups, respectively. Overall cost per patient of dual-controller therapy consisting of fluticasone propionate and the inhaled long-acting beta2-agonist salmeterol was lower than a regimen consisting of either another inhaled corticosteroid with salmeterol or an inhaled corticosteroid with a leukotriene modifier. The cost of asthma treatment failure (i.e., inpatient and emergency department) was similar between groups.