HEALTH AND ECONOMIC BENEFITS OF USING SINGLE VERSUS MULTIPLE INHALERS IN PATIENTS WITH ASTHMA- A SYSTEMATIC LITERATURE REVIEW
Author(s)
Zhang S1, King D2, Rosen V3, Ismaila A4
1GSK, Collegeville, PA, USA, 2Forest Systematic Reviews Limited, Twickenham, UK, 3OPTUM Life Sciences, Eden Prairie, MN, USA, 4GSK, Research Triangle Park, NC, USA
OBJECTIVES: Asthma can limit activities and reduce quality of life. With an increasing choice of medications and devices, comparative evidence may inform treatment decisions. This systematic literature review assessed evidence for using a single, fixed-dose combination (FDC) inhaler versus multiple inhalers to deliver the same medications for patients with asthma. METHODS: In 2016, Embase, PubMed and the Cochrane library were searched for publications reporting studies comparing any single FDC inhaler with multiple inhalers to deliver the same class of medications in adults and children with asthma. Publications were limited to English articles published since 1996 and congress abstracts published since 2013. Clinical, economic, adherence and medication burden endpoints were assessed. RESULTS: Of 2031 abstracts screened, 33 asthma studies were identified; 18 randomised controlled trials (RCTs; including non-inferiority and double-dummy designs), 11 retrospective, and 4 prospective studies. Findings from 15 RCTs reporting lung function, and 9 RCTs and 2 prospective studies reporting exacerbation rates, showed no significant differences between a single FDC inhaler and multiple inhalers. Two retrospective studies reported lower exacerbation rates with a single FDC inhaler than with multiple inhalers. Economic analyses from retrospective and prospective studies showed that a single FDC inhaler was associated with reduced health care resource use (n=6) and was cost effective (n=3) compared with multiple inhaler therapies. Three retrospective studies reported greater adherence with a single FDC inhaler than multiple inhalers, whereas 5 RCTs reported no difference in adherence. CONCLUSIONS: Different conclusions were found in the various investigated studies due to differences in study design. The efficacy (such as lung function and exacerbation rates) of a single FDC inhaler and multiple inhalers was comparable. Results from retrospective and prospective studies showed that using a single FDC inhaler was associated with decreased resource use and improved cost effectiveness compared with multiple inhalers. Funding: GSK (HO-16-13836)
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PMD17
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Respiratory-Related Disorders