Objective  To evaluate the cost-effectiveness of budesonide/formoterol powder inhalation (BF) versus salmeterol/fluticasone powder inhalation (SF) for the treatment of persistent asthma in adolescents, and to provide economic evidence and reference for clinical medication and decision-making.

Methods  From perspective of Chinese healthcare , a Markov model was established based on a prospective cohort study conducted by Shanghai Fudan University Affiliated Minhang Hospital. The cycle length was 7 days, and the time horizon was 6 years. A discount rate of 5% per year was applied. Clinical parameters including asthma acute exacerbation, treatment costs, and health utility values were obtained from relevant literature. The primary outcomes were direct medical costs, quality-adjusted life-years (QALYs), and incremental cost-utility ratio (ICUR). Cost-utility analysis was performed using TreeAge Pro 2022. The one-way sensitivity analysis and probabilistic sensitivity analysis were conducted to validate the robustness of the basic analysis results.

Results  Compared with SF group, BF group contributed to an incremental QALYs of 0.002 5 and reduced the cost by 7 043.93 yuan, which implied that BF group was a dominating treatment.

Results of one-way sensitivity analysis showed that SF price, BF price and Hazard ratio of asthma acute exacerbation (BF vs. SF) were the main sensitivity factors of model. Probabilistic sensitivity analysis demonstrated the probability of BF being cost-effective was about 80% within the willingness to pay threshold of 257 100 yuan/QALY.

Conclusions  It was found out in this study that BF was a more cost-effective option for the adolescents with persistent asthma compared with SF.

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