布地奈德+福莫特罗通过信必可都保方式传送对于哮喘和COPD的管理：与吸入器相比，改善吸入技术的非计划医疗费用的潜在影响
2017/08/08
摘要
背景：吸入糖皮质激素和长效β受体激动剂的固定剂量组合通常用于治疗哮喘和COPD。然而，信必可都保（布地奈德和福莫特罗，BF）吸入剂是最常规定的干粉吸入器，它与吸入技术差有密切关系，这可以导致疾病控制差和疾病管理成本增高。最近的一项研究表明，在使用新型DuoResp (BF)都保吸入器时，与BF吸入器相比较，患者吸入错误的几率更小。因此，将BF吸入器换为BF都保吸入器的患者可以改善吸入技术，并可能带来更好的疾病控制和医疗成本的节约。
方法：在德国、意大利、瑞典和英国建立三年来从BF吸入器换为BF都保的哮喘和COPD患者减少不良吸入技术的预算影响的模型。模型可以估算更改非计划的医疗事件的数量和相关成本。该模型考虑了两种情况：在方案1中，所有患者立即从BF吸入器换为BF都保，在方案2中，4%、8%和12%的患者分别在模型的第1、2、3年里改变吸入方式。
结果：在方案1中，德国、意大利、瑞典和英国的每位患者的成本节约总额分别为60.10欧元、49.67欧元、94.14欧元和38.20欧元。每个国家总成本节约分别为1亿86万欧元、1942万欧元、3665万欧元和1544万欧元。三年以上，估计597,754, 151,480, 228,986 和122,368医疗事件可以避免发生。在方案2中，成本节约总计分别为€807万 , €155万, €293万 and €123万。三年以上，估计47,850, 12,118, 18,319和 9789医疗事件可以避免发生。每位患者可以分别节约€4.81, €3.97, €7.53和 €3.06。
结论：将BF吸入器换为BF都保可以改善患者的疾病控制，并通过避免医疗事件的发生实现可观的医疗成本的节约，从而降低吸入技术差的影响。
Budesonide + formoterol delivered via Spiromax for the management of asthma and COPD: The potential impact on unscheduled healthcare costs of improving inhalation technique compared with Turbuhaler.
Lewis A1, Torvinen S2, Dekhuijzen PNR3, Chrystyn H4, Melani A5, Zöllner Y6, Kolbe K7, Watson AT1, Blackney M8, Plich A2.Author information
Abstract
BACKGROUND: Fixed-dose combinations of inhaled corticosteroids and long-acting β2 agonists are commonly used for the treatment of asthma and COPD. However, the most frequently prescribed dry powder inhaler delivering this medicine - Symbicort (budesonide and formoterol, BF) Turbuhaler - is associated with poor inhalation technique, which can lead to poor disease control and high disease management costs. A recent study showed that patients make fewer inhaler errors when using the novel DuoResp (BF) Spiromax inhaler, compared with BF Turbuhaler. Therefore switching patients from BF Turbuhaler to BF Spiromax could improve inhalation technique, and potentially lead to better disease control and healthcare cost savings.
METHODS:A model was developed to estimate the budget impact of reducing poor inhalation technique by switching asthma and COPD patients from BF Turbuhaler to BF Spiromax over three years in Germany, Italy, Sweden and the UK. The model estimated changes to the number, and associated cost, of unscheduled healthcare events. The model considered two scenarios: in Scenario 1, all patients were immediately switched from BF Turbuhaler to BF Spiromax; in Scenario 2, 4%, 8% and 12% of patients were switched in years 1, 2 and 3 of the model, respectively.
RESULTS: In Scenario 1, per patient cost savings amounted to €60.10, €49.67, €94.14 and €38.20 in Germany, Italy, Sweden and the UK, respectively. Total cost savings in each country were €100.86 million, €19.42 million, €36.65 million and €15.44 million over three years, respectively, with an estimated 597,754, 151,480, 228,986 and 122,368 healthcare events avoided. In Scenario 2, cost savings totalled €8.07 million, €1.55 million, €2.93 million and €1.23 million over three years, respectively, with 47,850, 12,118, 18,319, and 9789 healthcare events avoided. Savings per patient were €4.81, €3.97, €7.53 and €3.06.
CONCLUSIONS: We demonstrated that reductions in poor inhalation technique by switching patients from BF Turbuhaler to BF Spiromax are likely to improve patients' disease control and generate considerable cost savings through healthcare events avoided.
背景：吸入糖皮质激素和长效β受体激动剂的固定剂量组合通常用于治疗哮喘和COPD。然而，信必可都保（布地奈德和福莫特罗，BF）吸入剂是最常规定的干粉吸入器，它与吸入技术差有密切关系，这可以导致疾病控制差和疾病管理成本增高。最近的一项研究表明，在使用新型DuoResp (BF)都保吸入器时，与BF吸入器相比较，患者吸入错误的几率更小。因此，将BF吸入器换为BF都保吸入器的患者可以改善吸入技术，并可能带来更好的疾病控制和医疗成本的节约。
方法：在德国、意大利、瑞典和英国建立三年来从BF吸入器换为BF都保的哮喘和COPD患者减少不良吸入技术的预算影响的模型。模型可以估算更改非计划的医疗事件的数量和相关成本。该模型考虑了两种情况：在方案1中，所有患者立即从BF吸入器换为BF都保，在方案2中，4%、8%和12%的患者分别在模型的第1、2、3年里改变吸入方式。
结果：在方案1中，德国、意大利、瑞典和英国的每位患者的成本节约总额分别为60.10欧元、49.67欧元、94.14欧元和38.20欧元。每个国家总成本节约分别为1亿86万欧元、1942万欧元、3665万欧元和1544万欧元。三年以上，估计597,754, 151,480, 228,986 和122,368医疗事件可以避免发生。在方案2中，成本节约总计分别为€807万 , €155万, €293万 and €123万。三年以上，估计47,850, 12,118, 18,319和 9789医疗事件可以避免发生。每位患者可以分别节约€4.81, €3.97, €7.53和 €3.06。
结论：将BF吸入器换为BF都保可以改善患者的疾病控制，并通过避免医疗事件的发生实现可观的医疗成本的节约，从而降低吸入技术差的影响。
（中日友好医院呼吸与危重症医学科 禹汶伯 摘译 林江涛 审校）
（Respir Med. 2017 Aug;129:179-188. doi: 10.1016/j.rmed.2017.06.018. Epub 2017 Jun 27.）
（Respir Med. 2017 Aug;129:179-188. doi: 10.1016/j.rmed.2017.06.018. Epub 2017 Jun 27.）
Budesonide + formoterol delivered via Spiromax for the management of asthma and COPD: The potential impact on unscheduled healthcare costs of improving inhalation technique compared with Turbuhaler.
Lewis A1, Torvinen S2, Dekhuijzen PNR3, Chrystyn H4, Melani A5, Zöllner Y6, Kolbe K7, Watson AT1, Blackney M8, Plich A2.Author information
Abstract
BACKGROUND: Fixed-dose combinations of inhaled corticosteroids and long-acting β2 agonists are commonly used for the treatment of asthma and COPD. However, the most frequently prescribed dry powder inhaler delivering this medicine - Symbicort (budesonide and formoterol, BF) Turbuhaler - is associated with poor inhalation technique, which can lead to poor disease control and high disease management costs. A recent study showed that patients make fewer inhaler errors when using the novel DuoResp (BF) Spiromax inhaler, compared with BF Turbuhaler. Therefore switching patients from BF Turbuhaler to BF Spiromax could improve inhalation technique, and potentially lead to better disease control and healthcare cost savings.
METHODS:A model was developed to estimate the budget impact of reducing poor inhalation technique by switching asthma and COPD patients from BF Turbuhaler to BF Spiromax over three years in Germany, Italy, Sweden and the UK. The model estimated changes to the number, and associated cost, of unscheduled healthcare events. The model considered two scenarios: in Scenario 1, all patients were immediately switched from BF Turbuhaler to BF Spiromax; in Scenario 2, 4%, 8% and 12% of patients were switched in years 1, 2 and 3 of the model, respectively.
RESULTS: In Scenario 1, per patient cost savings amounted to €60.10, €49.67, €94.14 and €38.20 in Germany, Italy, Sweden and the UK, respectively. Total cost savings in each country were €100.86 million, €19.42 million, €36.65 million and €15.44 million over three years, respectively, with an estimated 597,754, 151,480, 228,986 and 122,368 healthcare events avoided. In Scenario 2, cost savings totalled €8.07 million, €1.55 million, €2.93 million and €1.23 million over three years, respectively, with 47,850, 12,118, 18,319, and 9789 healthcare events avoided. Savings per patient were €4.81, €3.97, €7.53 and €3.06.
CONCLUSIONS: We demonstrated that reductions in poor inhalation technique by switching patients from BF Turbuhaler to BF Spiromax are likely to improve patients' disease control and generate considerable cost savings through healthcare events avoided.
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