Cost effectiveness of asthma controller therapies: influence of disease severity and other variables.

A comprehensive literature review was conducted to compare the cost effectiveness of controller therapies for the treatment of persistent asthma. Health economic evaluations of asthma controllers demonstrate that inhaled corticosteroids (ICSs) are more cost effective than as-needed short-acting beta2-adrenergic agonists and alternative controller therapies in children and adults. Moreover, combination therapy with an ICS and a long-acting beta2-adrenergic agonist appears to be cost effective relative to ICSs or leukotriene-receptor antagonists (LTRAs) alone and to ICS/LTRA combination therapy for patients with more severe disease. Even in mild persistent asthma, ICS therapy provides significant clinical improvement at a savings in both direct and indirect costs.