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KMID : 0854720080280010026
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Korean Journal of Asthma, Allergy and Clinical Immunology
2008 Volume.28 No. 1 p.26 ~ p.34
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Economic Evaluations of Alternative Inhaled Steroid Medications in Patients with Asthma
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Kim Jin-Hyun
Lee Young-Hee
Kim Youn-Hee
Lee Gyung-Yi
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Abstract
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Background: Asthma requires enormous social costs and deteriorates quality of life. Inhaled corticosteroids (ICSs) including budesonide (BUD), fluticasone propionate (FP), and ciclesonide (CIC) are currently considered the standard therapy for patients with asthma.
Objective: Comparing cost-effectiveness of BUD, FP, CIC, and finding the best alternative.
Method: A systematic literature review from MEDLINE was performed to compare CIC with BUD or FP, measuring efficacy by FEV1 and morning PEF change. From a social perspective, costs consist of medications, related health services, and monitoring expenses, depending on the compliance rate.
Result: Assuming that CIC is not inferior to FP or BUD, and FP produces significantly greater FEV1 and change in morning PEF than BUD, annual drug cost per patient was highest in CIC group. However, a hospital cost of 449,760 won due to low compliance was added to FP and BUD groups, respectively. The estimated quality-adjusted life years were 1.2 years for asthmatics not taking ICS, 14.53 years for those taking FP or CIC, and 13.21 years for those taking BUD.
Conclusion: CIC is the most cost effective agent for asthma patients with poor compliance. A cost-utility analysis, however, shows that FP is the best alternative for patients with good compliance.
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KEYWORD
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Asthma, Economic Evaluation, Cost-effectiveness analysis, Corticosteroid, Ciclesonide
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