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Preliminary pharmacoeconomic analyses suggest that levalbuterol (LEV) therapy is associated with decreased outpatient asthma health care costs. OBJECTIVE: Examine treatment costs in asthma patients stratified by the number of prescribed controller medications (CM), an index of asthma severity. METHODS: Claims data on patients prescribed LEV and RAC were obtained from the PharMetrics Integrated Outcomes Database. Age‐ and sex‐matched samples of patients initiating therapy with LEV or RAC (no prescriptions for either agent in prior 6 months) were selected and their asthma‐related charges were assessed over 6 months following the initial prescription. RESULTS: 544 LEV‐treated patients were identified and matched to 544 RAC‐treated patients. 62% of RAC patients previously received no CM, 20% had 1 CM, and 18% had> 1 CM. Following RAC treatment 30% had 1 CM and 29% had> 1 CM. Use of leukotriene modifiers increased from 8% to 14% and corticosteroid use increased from 33% to 46%. Although LEV patients previously received more CM (41% no CM; 24% 1 CM; 34%> 1 CM), after treatment the percent with> 1 CM declined to 28%. Their leukotriene modifier use increased from 22% to 25% while long‐acting bronchodilator use decreased from 13% to 10%. In patients without prior CM, mean charges declined by similar amounts in both groups (LEV: $360, RAC: $306) following treatment. In patients with 1 CM, LEV was associated with a $116 reduction despite a $121 increase in pharmacy charges while RAC was associated with a $22 decrease. In patients with> 1 CM, LEV was associated with a $435 reduction in mean charges while RAC was associated with a $311 increase. CONCLUSIONS: Asthmatic patients treated with LEV required no additional CM and some patients reduced the number of CM. Cost reductions associated with LEV increased with severity.

Preliminary evidence suggests that levalbuterol (LEV), the therapeutically active isomer of albuterol, can improve clinical outcomes while reducing health care costs compared to racemic albuterol (RAC). OBJECTIVE: Explore the impact of LEV versus RAC on resource utilization, co‐medication use, and cost of therapy in asthmatics. METHODS: Claims data on patients prescribed LEV and RAC were obtained from the PharMetrics Integrated Outcomes Database. Age‐ and sex‐matched samples of patients initiating therapy with LEV or RAC (no prescriptions for either agent in prior 6 months) were selected and their asthma‐related charges were assessed over 6 months following the initial prescription. RESULTS: 544 LEV‐treated patients were identified and matched to 544 RAC‐treated patients. 70% of all patients were <12 years of age. 32% of RAC patients and 59% of LEV patients received asthma controller medication during the prior 6 months. Mean asthma‐related (pharmacy and medical) charges during the prior 6 months were $872 versus $587 in the LEV and RAC groups respectively. During the 6 months follow‐up period, controller medication use increased among RAC patients to 59%, while use among LEV patients remained unchanged. Overall mean charges decreased by $298 for LEV and $61 for RAC. In patients receiving concomitant controller medications, LEV was associated with a $247 decline in charges versus a $116 increase for RAC. Among patients treated in primary care (pediatricians, family practitioners, and internists), the reduction in mean charges was $262 for LEV, while RAC was associated with a $180 increase. CONCLUSIONS: 1) LEV was prescribed to patients who were “sicker” than those prescribed RAC; 2) Patients treated with RAC, but not LEV, tended to require additional controller medications; 3) LEV was associated with greater reduction in total cost compared to RAC, which in “sicker” and primary care patients was associated with increased cost.

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