PP-ICONS-Another Tool to Help Interpret Asthma Utilization Studies

The Editors Respond: The Diminishing Role of Montelukast in Asthma Therapy

“…8 We also appreciate Markson and colleagues bringing attention to their attempt to classify disease severity scores from pharmacy claims. Closer examination of the unpublished severity of disease assessment system, which Crownover correctly identified as not validated, 9 defines the second-most severe group (Group 3) for example as the use of either 2 or more pharmacy claims for oral corticosteroids (OCs) or no OC pharmacy claims and 6 or more pharmacy claims for short-acting betaagonists (SABAs, e.g., albuterol) or 1 pharmacy claim for an OC and 4 or more SABA pharmacy claims. We prefer to let readers judge whether no OC pharmacy claims and 6 or more SABA claims in 12 months accurately represents Step 3 Moderate Persistent Asthma, defined by the NAEPP EPR-2 as daily symptoms, exacerbations affecting activity occurring at least twice per week, night symptoms more than once weekly, daily short-acting requirement for SABAs, and peak expiratory flow variability more than 30%.…”

Health Care Utilization Determined From Administrative Claims Analysis for Patients Who Received Inhaled Corticosteroids With Either Montelukast or Salmeterol

“…Crownover 1 and Curtiss 2 published separate editorials that made reference to our article 3 on health care utilization among patients with asthma who were treated with inhaled corticosteroids (ICSs) in combination with either montelukast (MON) or salmeterol (SAL). The subject of Crownover' s editorial is application of the PP-ICONS tool 4 to skim research articles to quickly evaluate new publications.…”

“…The true value for money spent on montelukast is a subject of interest to virtually every managed care clinician and administrative pharmacist, as montelukast generated $2.976 billion in worldwide sales for the manufacturer in 2005, up 13.5% from $2.622 billion in 2004. Montelukast was cited in the company' s 2005 annual report as the leader in sales performance, among its portfolio of products, 1 and montelukast is projected to be the leading product in sales for the manufacturer through 2009. 2 Montelukast costs about $1,100 per patient per year at discounted managed care organization prices in the United States in 2006; in the 3 months ending May 31, 2006, it pushed its way to be the overall fourth-highest expenditure drug.…”