Cost-effectiveness of fluticasone propionate administered via metered-dose inhaler plus babyhaler spacer in the treatment of asthma in preschool-aged children

Chest. 2001 Dec;120(6):1835-42. doi: 10.1378/chest.120.6.1835.


Study objectives: To evaluate the cost-effectiveness of inhaled fluticasone propionate (FP) in children aged 12 to 47 months with asthma symptoms.

Design: A retrospective economic analysis conducted from the perspective of the Danish health-care system, based on clinical data from a 12-week study.

Setting: Thirty-three outpatient centers in nine countries.

Patients: Two hundred thirty-seven children aged 12 to 47 months with documented history of recurrent wheeze or asthma symptoms.

Interventions: Two dosages of FP, 100 microg/d and 200 microg/d, and placebo administered in two divided doses via a metered-dose inhaler and a Babyhaler (Glaxo Wellcome; Middlesex, UK) spacer device.

Measurements: Effectiveness in terms of asthma exacerbations, control of cough and wheeze symptoms, symptom-free days, overall direct costs of asthma management in Danish kroner at 1999 prices, and mean and incremental cost-effectiveness ratios.

Results: FP, 200 microg/d, was significantly more effective than placebo treatment in terms of the proportion of exacerbation-free patients (73.7% vs 59.8%; p = 0.025) and patients experiencing a > or = 25% improvement in cough symptoms (57.9% vs 39.0%; p = 0.018). The costs per exacerbation-free patient, per patient with a > or = 25% improvement in cough and wheeze symptoms from baseline, and per symptom-free day were lower in the FP groups than in the placebo group. The incremental cost-effectiveness ratios for these end points indicated that the additional benefits of FP, 200 microg/d, were achieved at a lower overall cost compared with placebo treatment.

Conclusions: From the perspective of the Danish health-care system, FP, 100 microg bid, administered via the Babyhaler inhalation device was cost-effective relative to standard therapy with bronchodilators alone.

Publication types

  • Clinical Trial
  • Comparative Study
  • Evaluation Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Androstadienes / administration & dosage
  • Androstadienes / adverse effects
  • Androstadienes / economics*
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / adverse effects
  • Anti-Asthmatic Agents / economics*
  • Asthma / drug therapy
  • Asthma / economics*
  • Child, Preschool
  • Cost-Benefit Analysis
  • Denmark
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Fluticasone
  • Humans
  • Infant
  • Male
  • National Health Programs / economics
  • Nebulizers and Vaporizers / economics*
  • Retrospective Studies
  • Treatment Outcome


  • Androstadienes
  • Anti-Asthmatic Agents
  • Fluticasone