The cost-effectiveness of low-dose budesonide as a Step 2 treatment for pediatric asthma in China.

Lay abstract In this study, low-dose budesonide was compared with montelukast as a Step 2 treatment among pediatric patients (aged 1-5 years) for costs and clinical outcomes in China. Over 1 year, patients receiving low-dose budesonide had fewer exacerbation events, incurred lower costs for treatment and exacerbation management and had slightly better quality of life, compared with patients receiving montelukast. The clinical benefits and cost savings suggest that the use of low-dose budesonide may help reduce the burden of persistent pediatric asthma in China. Aim: To compare the cost-effectiveness of low-dose budesonide versus montelukast among patients aged 1-5 years from a Chinese patient and healthcare payer perspective. Materials & methods: A Markov model based on exacerbation states was developed. Exacerbation was defined as the need for rescue therapy (mild exacerbation) or hoscopitalization (moderate-to-severe exacerbation). Inputs including efficacy (i.e., exacerbation rates), mortality, utilities, costs and treatment adherence were obtained from literature. Results: Compared with montelukast, low-dose budesonide led to fewer exacerbation events (1.44 vs 2.15), lower costs ( yen 3675 vs 4130) and slightly more quality-adjusted life years (0.974 vs 0.967) over 1 year. Conclusion: These findings may improve the use of low-dose budesonide, an economically and clinically preferable treatment to montelukast in pediatric patients.