A budget impact analysis of Spiromax® compared with Turbuhaler® for the treatment of moderate to severe asthma: a potential improvement in the inhalation technique to strengthen medication adherence could represent savings for the Spanish Healthcare System and five Spanish regions

Abstract

Josep Darbà,1 Gabriela Ramírez,2 Juan L García-Rivero,3 Sagrario Mayoralas-Alises,4 José Francisco Pascual,5 Albert Roger,6 Diego Vargas,7 Adi Bijedic8 1Department of Economics, Universitat de Barcelona, 2BCN Health Economics & Outcomes Research SL, 3Hospital Laredo, Cantabria, 4Hospital Ramón y Cajal, Madrid, 5Hospital General Universitario de Alicante, Alicante, 6Hospital Universitario Germans Trias i Pujol, Barcelona, 7Hospital de Alta Resolución el Toyo, Andalusia, 8Market Access and HEOR Department, TEVA Pharmaceutical, Madrid, Spain Objective: To assess the economic impact of the introduction of DuoResp® Spiromax® by focusing on a potential improvement in the inhalation technique to strengthen medication adherence for the treatment of moderate to severe asthmatics in Spain and five Spanish regions including Andalusia, Catalonia, Galicia, Madrid, and Valencia.Methods: A 4-year budget impact model was developed for the period 2015–2018 from the Spanish Healthcare System perspective. Budesonide–formoterol fixed-dose combination delivered by Turbuhaler® was considered to be the most appropriate comparator for assessing the budget impact with the introduction of DuoResp® Spiromax®. National and regional data on asthma prevalence were obtained from the literature. Input parameters on health care resources were obtained by consulting experts from different Spanish hospitals. Resources used included medical visits, emergency room visits, and hospitalizations. The average numbers of primary care and specialist visits per year were also gathered. Based on health care resource use per patient, the total treatment cost per patient was estimated.Results: The population with moderate to severe asthma treated with budesonide–formoterol fixed-dose combinations delivered by Turbuhaler® in 2015 was estimated to be 166,985 in Spain. Region-specific prevalence data resulted in 25,081, 12,392, 16,097, 17,829, and 15,148 patients in Andalusia, Catalonia, Galicia, Madrid, and Valencia, respectively. Based on the forecast uptake of DuoResp® Spiromax®, the total budget savings in Spain were expected to be €1.509 million over the next 4 years. Region-specific rates imply that the total savings were expected to be €229,706 in Andalusia, €90,145 in Catalonia, €188,327 in Galicia, €122,669 in Madrid, and €165,796 in Valencia over 2015–2018.Conclusion: The introduction of DuoResp® Spiromax®, which represents a potential improvement in the inhalation technique to strengthen medication adherence for the treatment of moderate to severe asthma, could represent savings for the Spanish National Health Society and five Spanish regions. Keywords: dry powder inhaler, economic evaluation, region-specific estimates, payers perspective

Keywords

• asthma
• inhalation technique
• adherence
• budget impact;