Cost-effectiveness of asthma control: an economic appraisal of the GOAL study

Briggs, A.H. , Bousquet, J., Wallace, M., Busse, W.W., Clark, T.J.H., Pedersen, S.E. and Baternan, E.D. (2006) Cost-effectiveness of asthma control: an economic appraisal of the GOAL study. Allergy, 61(5), pp. 531-536. (doi: 10.1111/j.1398-9995.2006.01038.x)

Abstract

<i>Background</i>: The Gaining Optimal Asthma ControL (GOAL) study has shown the superiority of a combination of salmeterol/fluticasone propionate (SFC) compared with fluticasone propionate alone (FP) in terms of improving guideline defined asthma control. <i>Methods</i>: Clinical and economic data were taken from the GOAL study, supplemented with data on health related quality of life, in order to estimate the cost per quality adjusted life year (QALY) results for each of three strata (previously corticosteroid-free, low- and moderate-dose corticosteroid users). A series of statistical models of trial outcomes was used to construct cost effectiveness estimates across the strata of the multinational GOAL study including adjustment to the UK experience. Uncertainty was handled using the non-parametric bootstrap. Cost-effectiveness was compared with other treatments for chronic conditions. <i>Result</i>: Salmeterol/fluticasone propionate improved the proportion of patients achieving totally and well-controlled weeks resulting in a similar QALY gain across the three strata of GOAL. Additional costs of treatment were greatest in stratum 1 and least in stratum 3, with some of the costs offset by reduced health care resource use. Cost-effectiveness by stratum was £7600 (95% CI: £4800–10 700) per QALY gained for stratum 3; £11 000 (£8600–14 600) per QALY gained for stratum 2; and £13 700 (£11 000–18 300) per QALY gained for stratum 1. <i>Conclusion</i>: The GOAL study previously demonstrated the improvement in total control associated with the use of SFC compared with FP alone. This study suggests that this improvement in control is associated with cost-per-QALY figures that compare favourably with other uses of scarce health care resources.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Briggs, Professor Andrew
• Authors: Briggs, A.H., Bousquet, J., Wallace, M., Busse, W.W., Clark, T.J.H., Pedersen, S.E., and Baternan, E.D.
• Subjects: R Medicine > RA Public aspects of medicine; R Medicine > RC Internal medicine; H Social Sciences > HG Finance
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences
• Journal Name: Allergy
• Publisher: Blackwell
• ISSN: 0105-4538
• Copyright Holders: Copyright © 2006 Blackwell
• First Published: First published in Allergy: European Journal of Allergy and Clinical Immunology 61(5):531-536
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher.