Costo Efectividad Salmeterol

VALUE IN HEALTH 14 (2011) S43–S47

available at www.sciencedirect.com

journal homepage: www.elsevier.com/locate/jval

Costo-Efectividad del Tratamiento de Salmeterol/Fluticasona en
Comparación con Leucotrieno Montelukast para el Control del Asma
Infantil
Kely Rely, MD, MPH, MS1,*, Sebastián Emanuel González McQuire, MS2, Pierre K. Alexandre, MPH, MS, PhD3,
Guillermo Salinas Escudero,MS4
1

Economista de la salud, Investigador principal, Consultor en Farmacoeconomía, Director CEAHealthTech, México D.F., México; 2Glaxo SmithKline
México D.F., México; 3Economista de la salud, Department of Mental Health – Bloomberg School of Public Health, Johns Hopkins University, Baltimore,
MD, USA; 4Economista de la salud, Hospital Infantil de México Federico Gómez, México D.F., MéxicoABSTRACT

Objective: To assess the incremental cost-effectiveness of SFC compared with MON for the control of persistent asthma in children.
Methods: We conducted an economic evaluation on a 12-week prospective randomized open-label parallel-group comparison of SFC versus MON in children with symptomatic asthma receiving inhaled corticosteroids and short-acting 2-agonists. Asthma-relatedmedication,
unscheduled physician contacts and hospitalizations were collected
prospectively. The main effectiveness measure was percentage of
asthma-controlled week with no short-acting 2-agonist use during
the study period. The analysis was conducted from the Mexican
healthcare perspective using 2010 unit cost prices, and only direct costs
were considered, all costs are reported in US dollar. .The model was
made fully probabilistic to reflect the joint uncertainty in the model
parameters. Results: Over the whole treatment period, the median
percentages of asthma-controlled weeks were 83.3% in the SFC group
and 66.7% in the MON group (SFC-MON difference, 16.7%; 95% CI, 8.3–
16.7; P 0.001 in favor of SFC). The mean total cost of the SFC regimen

Antecedentes
El asma se consideraun problema de salud, ya que afecta a 300
millones de personas en el mundo [1]. Actualmente, existe un aumento de su prevalencia y gravedad [2,3]. El asma es una enfermedad que afecta a los niños con factores de riesgo relacionados
con problemas genéticos y ambientales [4] y como enfermedad
crónica afecta la calidad de vida, el ausentismo escolar y produce
elevados costos sanitarios.
En Méxicose estima que los costos directos anuales están entre
32 a 35 millones de dólares [5]. Esta enfermedad representa uno de
los motivos de admisión a los servicios de salud con una alta hospitalización [6]. Un 70 % del costo total del asma está ocasionado
por su mal control [7], que repercute en los gastos de hospitalización, visitas a urgencias, fallecimientos de los pacientes, etc.

was $2,323 compared with $ 3,230 for the MON regimen. The SFC was
the dominant strategy (both more effective and less expensive) using
the SFC was associated with an incremental cost per additional asthmacontrolled of $ (5,467). Probabilistic sensitivity analysis tested numerous assumptions about the model cost and efficacy parameters and
found that the results were robust to most changes. Conclusions:This
analysis demonstrates that, compared with MON, SFC may be cost
saving from the Mexican health care perspective for the treatment of
pediatric patients with asthma. SFC provided a reduction in the number of severe exacerbations, frequent asthma symptoms and rescue
medication use. Incremental cost-effectiveness analysis indicated the
dominance of SFC because of both lower costs and greaterefficacy.
Palabras Claves: asma, costo/efectividad, montelukast, salmeterol/fluticasona.
Copyright © 2011, International Society for Pharmacoeconomics and
Outcomes Research (ISPOR). Published by Elsevier Inc.

La farmacoterapia actual está dirigida a la broncodilatación
para el alivio sintomático de los pacientes. Este tratamiento tiene
como objetivo el control de síntomas, incluidos los...