The technology of metered-dose inhalers and treatment costs in asthma: A retrospective study of breath actuation versus traditional press-and-breathe inhalers

Abstract This paper reviews the impact of the use of technologically dissimilar beta-agonist aerosols—the Maxai TM Autohale TM (pirbuterol acetate) breath-actuated aerosol and the traditional albuterol press-and-breathe inhaler—on the treatment costs of asthma. If, as clinical evidence would suggest, the breath-actuated aerosol is not only as effective as an albuterol inhaler with a spacer, but is easier to use and results in more optimal beta-agonist use by patients, then one might consider the hypothesis that patients possessing a breath-actuated inhaler would, ceteris paribus, experience lower asthma-related treatment costs—principally, those medical costs associated with fewer emergency room visits and hospitalizations. This hypothesis is considered from the perspective of a retrospective claims database study of patients who used one or the other beta-agonist inhaler exclusively. At the descriptive level, costs of treatment for patients using the press-and-breathe inhaler are estimated to be 16.5% greater than costs for patients using the breath-actuated inhaler. In the multivariate analysis, the presence of the breath-actuated inhaler (in a dummy variable analysis) was not only statistically significant ( P TM Autohale TM ranged from 8.7% to 11.7%, with medical cost savings estimated at 14.6%.