As-Needed Inhaled Corticosteroid-Formoterol in a Single Inhaler Compared to Inhaled Corticosteroid-Albuterol in Separate Inhalers as Reliever Therapy in Mild Pediatric Asthma: A Cost-Utility Analysis.

Objectives: Since 2019 as-needed low-dose ICS-formoterol in a single inhaler has been recommended for treatment of mild asthma in children aged more than 12 years. Alternatively, the use of ICS-albuterol has been proposed in countries where ICS-formoterol is not available or affordable. The aim of the present study was to evaluate the cost-utility of as-needed ICS-albuterol in separate inhalers compared to ICS-formoterol in a single inhaler as reliever therapy in pediatric patients with mild asthma living in Colombia.

Methods: A Markov-type model was developed to estimate the costs and health outcomes of a simulated cohort of pediatric patients with mild asthma treated for 12 months. The effectiveness data and transition probabilities were obtained from relevant randomized clinical trials (RCTs). Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs).

Results: The base-case analysis showed that compared with the use of as-needed ICS-albuterol in separate inhalers, the use of ICS-formoterol in a single in pediatric patients with mild asthma was associated with lower costs (US$475.51 vs. 735.33 average cost per patient) and the greatest gain in QALYs (0.9367 vs. 0.9352 QALYs on average per patient), thus leading to dominance.

Conclusions: Compared with the use of as-needed ICS-albuterol in separate inhalers, the use of ICS-formoterol in a single inhaler as reliever therapy is cost-effective in patients aged 12 years or more with mild asthma, because it showed a greater gain in QALYs at lower total treatment costs.