[Cost-effectiveness of fluticasone propionate for asthma episodes in Japanese patients with asthma--Fluticasone Investigation of Asthma Episode (FINE) study].

BACKGROUND: To discuss and estimate the economic benefits gained by fluticasone propionate (FP) for patients with asthma over hospitalization, emergency room visit, unscheduled visit, and absence (representative by asthma-related episode). METHOD: Asthma-related episodes in pre and post 6 months of FP use were derived from a survey of FP on asthma-related episodes (FINE study). Medical cost was evaluated by macro-cost estimate and productivity loss by human capital approach. RESULTS: Discussion of asthma-related episodes in-between before and after the use of FP in eight hundred ninety-eight valuable subjects revealed that FP use significantly reduced asthma-related episodic costs of approximately 120,000 yen (p<0.001), whereas total drug acquisition costs for being newly consumed FP, leukotriene receptor antagonists, inhaled short-acting beta2 agonists, etc were significantly increased by approximately 16,000 yen. Moreover, while significantly avoiding productivity loss of approximately about 35,000 yen it totally provided cost-savings of about 70,000 yen at the patients' viewpoint. When sensitivity analyses were performed by adjusting the confounding factors using analysis of covariance, the aforementioned base case results might be persistent. For safety of FP, some adverse events related to the use of FP were identified of about 2.0%, and there were not any serious ones at all. CONCLUSION: The economic evaluation of FP demonstrated that it is sufficient, whereas an acquisition cost was increased. Use of FP economically impacts on Japanese society and patients.