Kulikov A.Y., Makarova E.I. 303

Pharmacoeconomic analysis of continuation of use of symbicort® turbuhaler® as the sole inhaler for bronchial asthma therapy

Control of bronchial asthma (BA) is a key principle of disease treatment. One of the factors resulting in uncontrolled BA is incorrect use of an inhalation device and, as a consequence, low adherence to therapy. According to research data, up to 94% of patients, depending on the type of delivery system, make mistakes during application, resulting in inconsistent dosage and reduced efficacy. These factors may contribute toward an increase in costs of the healthcare system and decrease in the quality of life of patients. For example, an unapproved change of the inhaler may lead to reduced BA control and, as a result, growing expenses for medical services despite lower initial costs of pharmacotherapy. Availability of a wide range of medications and devices for delivering them, as well as limited financial resources of the healthcare system inspired a pharmacoeconomic assessment of various schemes of BA therapy. According to the cost analysis results, the provided amounts of direct and indirect costs for one-year therapy with Symbicort® Turbuhaler® as the sole inhaler is on average 4.5% lower than the costs of treatment with DuoResp Spiromax®, Formisonid-Nativ®, Foradil Combi®, Foster®, Seretide® and Seretide® Multidisk®. A budget impact analysis demonstrated that switching of patients from therapy with budesonis/formoterol Turbuhaler® as the sole inhaler to therapy with DuoResp Spiromax®, Formisonid-Nativ®, Foradil Combi®, Foster®, Seretide® and Seretide® Multidisk® entails additional average budget expenditures of RUB 4 mln per annum due to increased hospitalization frequency per 106 cases, more frequent calls for ambulance per 364 cases, more frequent visits to outpatient settings and polyclinics per 180 cases, as well as more days of temporary disability per 1 862 days - every figure given per 1,000 patients with BA. It is, therefore, clinically and economically reasonable that patients initially receiving Symbicort® Turbuhaler® as a support maintenance therapy to continue therapy using the same medication.
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