A cost-effectiveness analysis of breath-actuated metered-dose inhalers.

Managed care plans evaluate therapeutic alternatives to identify the most cost-effective medications for asthma. Three hundred one patients with asthma were randomized to receive the beta-agonist pirbuterol from either a manually operated metered dose inhaler (MDI) or a breath-actuated inhaler (BAI). Cost effectiveness was evaluated by the cost of the beta-agonist medication used and patient-reported outcomes. No significant differences between the two groups appeared in baseline or follow-up outcomes, which were assessed by self-reported health status and spirometry. However, patients receiving pirbuterol from BAIs used 23% less than those patients who received the drug from MDIs.