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Abstract
The National Heart, Lung and Blood Institute guidelines for the treatment of asthma suggest that inhaled corticosteroids, with the addition of a long-acting bronchodilator, may be the most effective long-term control medication for asthma. Five inhaled corticosteroids are approved for use in the USA, including beclomethasone dipropionate, budesonide, flunisolide, triamcinolone acetonide and fluticasone propionate. Fluticasone propionate (Flixotide®) and the long-acting β2 agonist salmeterol (Serevent®), are now available in the USA together in an easy to use dry powder inhaler Advair®. The cost-effectiveness of this combination in the treatment of persistent asthma is reviewed. This review evaluates all the cost-effectiveness studies comparing fluticasone propionate and salmeterol from two separate inhalers or one single inhaler available in the literature. Cost-effectiveness was compared with inhaled corticosteroids alone, leukotriene receptor antagonists and other combination therapies in patients with persistent asthma.