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 ® .

Background: Fixed-dose combinations of inhaled corticosteroids and long-acting β ₂ 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.
(Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)