Symbicort - Cost effectiveness

1.	Symbicort® is simply too expensive

2.	Can Symbicort® be more cost effective than current asthma therapy?

1. Symbicort® is simply too expensive

Symbicort is a cost-effective medication. Symbicort is designed for patients in need of both an inhaled steroid and a long-acting ß2-agonist, and compared to the mono-components (Pulmicort and Oxis), Symbicort has a competitive price. Recent data has shown that asthma control is better managed in patients treated with Symbicort than with the monoproducts in separate inhalers. The time to first exacerbation is shorter and the number of discontinuations from the study was significantly higher in patients treated with the monoproducts as compared with Symbicort. Furthermore, the use of a single inhaler will simplify therapy for all patients and a simple-to-use inhaler will provide patient advantages in terms of compliance and satisfaction with treatment. Symbicort therefore provides a better control of the patients' asthma condition which in turn lead to a significant lower health care costs.

The cost-effectiveness of Symbicort was investigated in 342 patients from Sweden in a trial which compared two inhalations of Symbicort 160/4.5mg twice daily with the corresponding doses of Pulmicort and Oxis in separate inhalers. Symbicort is found to have significantly lower direct treatment costs compared with Pulmicort and Oxis, resulting in a savings of SEK878 (US$91.20)/patient over the 6-month duration of the study.

2. Can Symbicort® be more cost effective than current asthma therapy?

The cost-effectiveness of Symbicort was evaluated against fluticasone in patients already using inhaled corticosteroids. The study was a double-blind, double-dummy, multicentre, parallel-group study including patients with moderate asthma (Ericsson et al, 2001). A total of 274 patients were allocated to 12 weeks treatment with either Symbicort 160/4.5mg twice daily or fluticasone 250mg twice daily. Results demonstrated that total costs were 54% lower for the Symbicort treatment group in Germany and was mainly due to lower costs associated with uncontrolled episodes of the disease (p<0.05). Costs were 40% lower also in the Netherlands, but statistical significance was not reached.

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