Cost-effectiveness of formoterol and salbutamol as asthma reliever medication in Sweden and in Spain
Corresponding Author
B. Lindgren
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Björn Lindgren, Lund University Centre for Health Economics (LUCHE), Box 705, SE-220 07 Lund, Sweden Tel.: +46 46 222 0659 Fax: +46 46 222 0651 Email: [email protected]Search for more papers by this authorM.R. Sears
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorM. Campbell
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorC. Villasante
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorS. Huang
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorA. Lindh
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorW. Petermann
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorK. Svensson
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorF. Berggren
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorR.A. Pauwels
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authoron the behalf of the RELIEF study investigators
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorCorresponding Author
B. Lindgren
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Björn Lindgren, Lund University Centre for Health Economics (LUCHE), Box 705, SE-220 07 Lund, Sweden Tel.: +46 46 222 0659 Fax: +46 46 222 0651 Email: [email protected]Search for more papers by this authorM.R. Sears
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorM. Campbell
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorC. Villasante
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorS. Huang
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorA. Lindh
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorW. Petermann
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorK. Svensson
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorF. Berggren
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorR.A. Pauwels
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authoron the behalf of the RELIEF study investigators
Lund University Centre for Health Economics, 1 Lund University, Lund, Sweden, Firestone Institute for Respiratory Health, 2 St Joseph's Healthcare and McMaster University, Hamilton, Canada, Department of General Practice, 3 University of Glasgow, Glasgow, Scotland, Department of Respiratory Diseases, 4 Hospital Universitaro La Paz, Madrid, Spain, Pulmonary Department, 5 Ruijin Hospital, Shanghai Second Medical University, Shanghai, China, Husläkarna Österåker, 6 Åkerberga, Sweden, Department of Internal Medicine, 7 Brüderkrankenhaus, Paderborn, Germany, Clinical Science, 8 AstraZeneca R&D Lund, Lund, Sweden, Department of Respiratory Diseases, 9 University Hospital, Ghent, Belgium
Search for more papers by this authorSummary
This study aimed to evaluate the cost-effectiveness of formoterol (Oxis®) Turbuhaler® 4.5 µg and salbutamol 200 µg as reliever medications in Sweden and Spain. The study used data on effectiveness (exacerbations and symptom-free days) and resource utilisation from an open, 6-month, parallel-group, multicentre randomised trial with 18,124 asthma patients in 24 countries. Country-specific unit costs for Sweden and for Spain were used to transform resource utilisation data into costs. Total healthcare costs were not significantly different between formoterol and salbutamol dry powder inhalers in Sweden, whereas in Spain, the healthcare costs were 20% higher for formoterol vs. salbutamol pressurised metered dose inhalers. Total healthcare costs increased with disease severity, defined according to the Global Initiative for Asthma guidelines. Compared with salbutamol, formoterol produced statistically significant improvements in effectiveness, less reliever and maintenance medication usage, reduced healthcare resource utilisation, with no increase or a limited increase in healthcare cost.
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