Overuse of Inhaled Corticosteroids and Long-Acting Beta Agonist Combination Therapy in Patients with Mild Asthma

Investigators: R. Thomas Manley, BSPharm; Mark Wong, PharmD; William Chen, PhD; Steve Bowlin, MD; Luis M. Salmun, MD

Presented by Thomas Manley of the Medco Research Institute^® at The American College of Allergy, Asthma & Immunology 2010 Annual Scientific Meeting

- This analysis compared medical and pharmacy costs and clinical outcomes of mild asthma patients taking an inhaled corticosteroid (ICS) and long-acting beta agonist (LABA) combination versus an ICS alone.

- According to national guidelines, ICS monotherapy is the preferred treatment for mild asthma and combination therapy should be reserved for patients with moderate to severe asthma unable to achieve and maintain control of their asthma on an ICS alone.

- The study evaluated 8,424 patients treated for mild asthma and found that 5,523 were on combined ICS/LABA therapy and 2,901 were using an ICS alone.

- Among the two groups of patients, there was no significant difference in their use of acute asthma medications, emergency room visits or hospitalizations, indicating that there was no additional clinical benefit gained from using the combined therapy compared to ICS monotherapy.

- The average asthma-related health care costs for those using the combination ICS/LABA therapy were $264 higher per patient per year than those using the ICS treatment alone.

- The findings confirm that ICS/LABA combination use is prevalent in mild asthma patients and is associated with increased asthma-related pharmacy and total healthcare costs with no observed clinical benefit, based on pharmacy and medical claims, when compared to ICS alone in this patient population.