Analysis of the Effectiveness and Cost Benefit of Leukotriene Modifiers in Adults With Asthma in the Ohio Medicaid Population

Health economics of asthma: assessing the value of asthma interventions

“…Seven additional studies compared combination vs monotherapy (36,40,44,49,53,55,61). Eight studies compared monotherapy vs monotherapy (38,41,42,45,46,51,56,58). Four studies compared add-on omalizumab vs usual care (39,47,57,60).…”

“…Only five studies did not come to this conclusion. Of these, one study of leukotriene modifiers concluded that they were dominated by non-LM use (42). Two studies concluded that the additional cost of omalizumab was not worth the observed benefits for most patients with severe asthma (47,60).…”

More Evolution of the Evidence in Asthma Disease Management-SMART Versus GOAL Clinical Trials Debate the Cost-Benefit of LABA While the Value of Leukotriene Modifiers, Particularly Montelukast, Is Uncertain

“…1 Montelukast is on the radar screen of every managed care pharmacist with responsibility for drug benefit costs and determining the value of alternate drug therapy. 24 Montelukast had community pharmacy sales of $1.85 billion in 2004, placing it at rank number 14 by expenditure among all brand-name drugs.…”

Chasing Quality - Clinical Practice Guidelines and HEDIS Measures of Asthma and Depression Therapy Management

“…1 Heaton et al challenge the value of leukotriene modifiers, currently recommended as second-line therapy in the treatment of asthma. 2 Robinson et al found an above-average rate of adherence to one of the quality measures in the Health Plan Employer Data and Information Set (HEDIS) in the treatment of depression. 3 Winterbottom et al found a low rate of adherence to a clinical practice guideline for the use of gabapentin for neuropathic pain in usual care versus a clinical pharmacy consult.…”

“…2 Based upon the 3 clinical outcomes of emergency room visits, hospitalizations for asthma, and the use of oral prednisone ("steroid burst") to indicate exacerbation of asthma, these authors concluded that LM use was not more effective than nonuse. Worse than no improvement in these 3 clinical outcomes, LM users appeared to have more ER visits, a higher rate of hospitalization, and a higher rate of use of oral prednisone bursts.…”