FP/FORM Versus FP/SAL Within Clinical Practice: An Updated Budget Impact Analysis in Asthma

Abstract

IntroductionPressurized metered-dose inhalers (pMDI) such as fluticasone propionate and salmeterol (FP/SAL) are commonly used for the treatment of asthma in the UK. Previously, a budget impact analysis demonstrated that use of FP and formoterol fumarate (FP/FORM) pMDI as an alternative to FP/SAL pMDI, would be a cost-saving option for the UK National Health Service (NHS). This budget impact analysis aimed to update the existing analysis with prescription volume data and real-world evidence since the introduction of FP/FORM to the UK market.MethodsPatient Data (IMS Information Solutions UK Ltd) moving annual total (MAT) August 2015 were used to ascertain the number of units of pMDI prescribed. Annual costs to the NHS in terms of drug, administration, monitoring and adverse event costs, were used to estimate the potential budget impact for FP/FORM and FP/SAL. Costs were calculated for current prescription volumes (12% FP/FORM, 88% FP/SAL), and for different prescription volume scenarios (FP/FORM at 0%, 25%, 50% and 100%). Real-world evidence and budget impact at a clinical commissioning group (CCG) level were also considered.ResultsTotal annual costs per person year were less with FP/FORM (£625) than with FP/SAL (£734). Annual costs to the NHS based on the current prescription volumes and clinical trial data were estimated at £210.0M, however, based on real-world evidence, costs were estimated at £179.8M. For all scenarios with increased FP/FORM prescription volumes, the annual total costs to the NHS decreased. This was reflected at a CCG level.ConclusionThe use of FP/FORM as an alternative to FP/SAL can result in cost savings for the NHS when assessing drug, administration, monitoring and adverse events costs. The inclusion of data released since the launch of FP/FORM within the budget impact analysis demonstrates that the potential cost savings to the NHS that were previously published are being translated to clinical practice.FundingMundipharma, UK.

<p>Perspective on the Budgetary Impact of FP/FORM pMDI on Treatment and Management of Exacerbation in Moderate-to-Severe Asthma Patients in Singapore</p>

“…37 A budget impact analysis in the UK also determined that FP/FORM share of 50% would be realistic usage data in a clinical setting. 19 Apart from direct drug costs, our model demonstrated that the increased access to FP/FORM and subsequent improvements in exacerbation control would provide cost savings for the management of moderate-to-severe asthma in Singapore, further to previous evidence showing that the use of FP/FORM has been associated with a lower incidence of exacerbations compared to the use of FP/SAL or BUD/FORM. 5 Similarly, previous real-world studies have shown that uncontrolled exacerbations were associated with increased healthcare resource use and subsequently an increase in healthcare costs.…”

“…16,17 Furthermore, European studies reported that the use of FP/FORM was associated with a low asthmarelated healthcare resource utilization and was shown to be cost-effective in clinical settings. [17][18][19] Although these data imply the potential of FP/FORM in improving exacerbation control and subsequently reducing healthcare resource utilization in a clinical setting, widespread use of FP/FORM is limited by a lack of government reimbursement in many countries. Singapore has been ranked as an intermediate risk country for asthma prevalence.…”

An innovative corticosteroid/long-acting β2-agonist breath-triggered inhaler: facilitating lung delivery of fluticasone propionate/formoterol fumarate for the treatment of asthma

“…An extensive clinical dataset exists for FP/FORM administered via a pMDI (Table 2) [29][30][31][32][33][34][35][36][37][38]. Furthermore, long-term data from two clinical studies have demonstrated good efficacy, safety, and tolerability with this ICS/LABA combination, including a low rate of exacerbations, over study periods of up to 60 weeks [33,35].…”

Initiating or changing to a fixed-dose combination of Fluticasone propionate/Formoterol over Fluticasone propionate/Salmeterol: A real-life effectiveness and cost impact evaluation

“…The prescription of a more cost-effective, yet equally efficacious, treatment has the potential to positively influence the economic burden of asthma care. Within the UK, Seretide ® , a formulation of FP/SAL, has the greatest volume of prescribed units to treat patients with asthma [21]. A recent alternative, Flutiform ® , a formulation of FP/FOR, was launched in the UK in September 2012 and currently accounts for only 4.6% of overall ICS/LABA units prescribed for patients with asthma compared with the 51.8% prescribed Seretide ® [21].…”

“…Within the UK, Seretide ® , a formulation of FP/SAL, has the greatest volume of prescribed units to treat patients with asthma [21]. A recent alternative, Flutiform ® , a formulation of FP/FOR, was launched in the UK in September 2012 and currently accounts for only 4.6% of overall ICS/LABA units prescribed for patients with asthma compared with the 51.8% prescribed Seretide ® [21]. Our previous studies found that 88.4% of patients that were switched from FP/ SAL to FP/FOR remained on the new therapy, suggesting a high retention rate for FP/FOR [22].…”