Background: Administration of multiple doses of inhaled impratropium bromide and salbutamol represents the first-choice treatment for severe asthmatic crisis. However, there is a scarce evidence demonstrating that this therapeutic intervention in cost-effective.
Objective: To determine cost-effectiveness relationship related to administration of ipratropium bromide in the treatment of severe asthmatic crisis in adults at two hospitals in Montevideo, Uruguay.
Material and methods: The cost of each treatment was estimated in U$S 0.9 when drug was administered by a metered dose pressurized inhaler (MDI) or U$S 1.7 by using a jet nebulizer (NEB).
Results: A monetary saving per patient (considering a median of five days of hospitalization and a risk reduction of 0.17) of U$S 30 with MDI or U$S 29 with NEB was observed in the public practice, and a saving of U$S 78 and 77, respectively in the private practice. The total annual monetary saving was of U$S 3,101 with MDI and U$S 2,897 with NEB in the public practice, and of U$S 4,979 and U$S 4,830 in the private practice. A two-way sensitivity analysis taking into account the length of hospitalizations and the risk reduction did not modify significantly the results.
Conclusions: The treatment of adults with severe acute asthma by using ipratropium bromide results cost-effective, leading to a significant saving of resources.