Budesonide + formoterol delivered via Spiromax® for the management of asthma and COPD: The potential impact on unscheduled healthcare costs of improving inhalation technique compared with Turbuhaler®

Respir Med. 2017 Aug:129:179-188. doi: 10.1016/j.rmed.2017.06.018. Epub 2017 Jun 27.

Abstract

Background: Fixed-dose combinations of inhaled corticosteroids and long-acting β2 agonists are commonly used for the treatment of asthma and COPD. However, the most frequently prescribed dry powder inhaler delivering this medicine - Symbicort® (budesonide and formoterol, BF) Turbuhaler® - is associated with poor inhalation technique, which can lead to poor disease control and high disease management costs. A recent study showed that patients make fewer inhaler errors when using the novel DuoResp® (BF) Spiromax® inhaler, compared with BF Turbuhaler®. Therefore switching patients from BF Turbuhaler® to BF Spiromax® could improve inhalation technique, and potentially lead to better disease control and healthcare cost savings.

Methods: A model was developed to estimate the budget impact of reducing poor inhalation technique by switching asthma and COPD patients from BF Turbuhaler® to BF Spiromax® over three years in Germany, Italy, Sweden and the UK. The model estimated changes to the number, and associated cost, of unscheduled healthcare events. The model considered two scenarios: in Scenario 1, all patients were immediately switched from BF Turbuhaler® to BF Spiromax®; in Scenario 2, 4%, 8% and 12% of patients were switched in years 1, 2 and 3 of the model, respectively.

Results: In Scenario 1, per patient cost savings amounted to €60.10, €49.67, €94.14 and €38.20 in Germany, Italy, Sweden and the UK, respectively. Total cost savings in each country were €100.86 million, €19.42 million, €36.65 million and €15.44 million over three years, respectively, with an estimated 597,754, 151,480, 228,986 and 122,368 healthcare events avoided. In Scenario 2, cost savings totalled €8.07 million, €1.55 million, €2.93 million and €1.23 million over three years, respectively, with 47,850, 12,118, 18,319, and 9789 healthcare events avoided. Savings per patient were €4.81, €3.97, €7.53 and €3.06.

Conclusions: We demonstrated that reductions in poor inhalation technique by switching patients from BF Turbuhaler® to BF Spiromax® are likely to improve patients' disease control and generate considerable cost savings through healthcare events avoided.

Keywords: Asthma; Budget impact; COPD; Inhalation technique; Spiromax.

MeSH terms

  • Administration, Inhalation
  • Adrenergic beta-2 Receptor Agonists / therapeutic use
  • Asthma / drug therapy*
  • Asthma / economics
  • Asthma / epidemiology
  • Bronchodilator Agents / therapeutic use
  • Budesonide / administration & dosage
  • Budesonide / therapeutic use*
  • Budesonide, Formoterol Fumarate Drug Combination / administration & dosage
  • Budesonide, Formoterol Fumarate Drug Combination / economics
  • Budesonide, Formoterol Fumarate Drug Combination / therapeutic use*
  • Dry Powder Inhalers / economics*
  • Dry Powder Inhalers / statistics & numerical data
  • Formoterol Fumarate / administration & dosage
  • Formoterol Fumarate / therapeutic use*
  • Germany
  • Glucocorticoids / therapeutic use
  • Health Care Costs / trends*
  • Humans
  • Italy
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / economics
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Sweden

Substances

  • Adrenergic beta-2 Receptor Agonists
  • Bronchodilator Agents
  • Budesonide, Formoterol Fumarate Drug Combination
  • Glucocorticoids
  • Budesonide
  • Formoterol Fumarate