American Thoracic Society
Nebulized Levalbuterol in Elderly Patients with Asthma
Speaker: Ronald J. Ozminkowski, PhD, Senior Economist, Outcomes Research and Economics, Research and Policy Group, The Medstat Group, Thomson Corporation, Ann Arbor, Michigan.
In an exploratory analysis of data collected on the management of elderly Medicaid patients with clinical with nebulized levalbuterol (Xopenex®, Sepracor, Inc.) resulted in a substantial cost savings when compared with the standard use of racemic albuterol sulfate (AccuNeb®, Dey; Ventolin®, GlaxoSmithKline).
From 2001 through 2002, the Medstat Market Scan Medi-caid Database was used to identify Medicaid patients with a first prescription for levalbuterol or racemic albuterol. Health care utilization costs, such as doctors’ and emergency department visits, and associated costs were compared across six month pre-index and six-month post-index periods for 913 patients taking nebulized levalbuterol and for 22,566 patients treated with racemic albuterol.
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According to this analysis, more than twice as many patients treated with racemic albuterol needed emergency department care during the post-index period than in the pre-index period, compared with the patients receiving levalbuterol. The fewer emergency department visits in the levalbuterol group accounted for a median cost savings of $1,145 per patient. Overall, considering all aspects of the differences in cost by
Dr. Prescott is a medical, health and science writer based in San Diego, California, and a former medical microbiologist and clinical pathologist for the World Health Organization. Sharon Prescott, a medical and health writer based in San Diego, has worked in the Division of Cardio-thoracic Surgery, the Department of Anesthesia, and the Department of Community Medicine at the University of California, San Diego, School of Medicine.
treatment, the levalbuterol patients spent less money than the patients receiving racemic albuterol.
Add-on Omalizumab in Asthma Exacerbations
Speaker: Sally E. Wenzel, MD, Professor and Co-Director, Clinical Research Unit, Medicine, National Jewish Medical and Research Center, and Professor of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Science Center, Denver, Colorado.
Add-on therapy with omalizumab (Xolair®, Genentech, Novartis), the first humanized therapeutic monoclonal antibody for the treatment of asthma that was approved to target the antibody immunoglobulin E (IgE), significantly reduced the rate of asthma exacerbations in patients with severe persistent asthma who required oral corticosteroids.
Although add-on omalizumab therapy has been effective in reducing the number of exacerbations in patients with severe persistent asthma, investigators wanted to determine its effects on the subgroup of patients requiring oral corticosteroids. They pooled and analyzed data from seven controlled trials of omalizumab in patients with severe IgE-mediated asthma. In five double-blind studies, omalizumab was added to current asthma therapy and compared with placebo, and in two open-label studies, omalizumab was compared with asthma therapy alone. Of 4,273 patients in the seven studies, 444 patients were receiving maintenance oral corticosteroid therapy and 3,829 patients were not.
Compared with placebo, omalizumab significantly reduced the exacerbation rate annually by 37% in patients needing oral corticosteroids. This decrease was similar to the 37% reduction in exacerbations in the patients who did not require oral corticosteroids; however, the reduction reported in the patients needing oral corticosteroids was greater in absolute terms because of the higher exacerbation rates seen in these patients, indicative of their more severe disease. Apcalis Oral Jelly