Perspective on the Budgetary Impact of FP/FORM pMDI on Treatment and Management of Exacerbation in Moderate-to-Severe Asthma Patients in Singapore

Sebastien Boisseau,¹ Murtaza Qasuri,¹ Weng Tong Ho,¹ Wrik Ghosh,² Yacine Hadjiat<sup>1

1</sup>Mundipharma Singapore Holding Pte Limited, Singapore; ²Costello Medical Singapore Pte Ltd, Singapore

Correspondence: Yacine Hadjiat
Mundipharma Singapore Holding Pte Limited, 12 Marina View, #22-01 Asia Square Tower 2, 018961, Singapore
Tel +65 65111165
Fax +65 65111167
Email Yacine.Hadjiat@mundipharma.com.sg

Purpose: Reducing the risk of exacerbation is a long-term goal of managing moderate-to-severe asthma. The use of fluticasone propionate/formoterol fumarate dihydrate (FP/FORM) pressurized metered-dose (pMDI, Flutiform^®), a type of inhaled corticosteroid (ICS) and long-acting β 2 agonist (LABA) fixed-dose combination, has been associated with lower oral corticosteroid-requiring exacerbation rates than other ICS/LABA fixed-dose combinations, fluticasone propionate/salmeterol xinafoate (FP/SAL) and budesonide/formoterol fumarate (BUD/FORM). This study presents the first budget impact analysis of drug and exacerbation management cost savings associated with the increased access to FP/FORM compared to the currently available ICS/LABAs for treating moderate-to-severe asthma in Singapore.
Patients and Methods: A budget impact model showed changes to annual drug and exacerbation costs over 5 years for patients with moderate-to-severe asthma in Singapore, following the inclusion of FP/FORM on a government subsidy list. The eligible patient population was identified based on national statistics data. Different treatment costs pertaining to the population were applied according to the usage data (IQVIA Singapore National Sales Data) for different scenarios. Drug costs were obtained from public-sector hospitals. Exacerbation management costs were obtained from literature searches.
Results: The analysis showed that increased access to FP/FORM as a result of switching from FP/SAL could help achieve drug (S$1,042,289) and exacerbation management (S$223,550) cost savings over 5 years. In the scenario where patients switched from BUD/FORM, greater drug (S$2,572,797) and exacerbation management (S$256,781) cost savings were observed over 5 years.
Conclusion: The analysis provides a perspective that the increased access to FP/FORM could help achieve drug and exacerbation cost savings for the treatment of moderate-to-severe asthma.

Keywords: ICS/LABA, asthma exacerbation, treatment cost, Flutiform^®, Fluticasone/formoterol, reimbursement