Giving multiple dose anticholinergics with inhaled beta2-agonists for children or adolescents presenting to casualty departments with severe, acute asthma would result in cost savings, according to a cost effectiveness analysis performed by Dr Joanne Lord (Health Care Evaluation unit, St George's hospital, London) and colleagues.
The group estimates that, allowing for the different cost of hospital admission throughout England, the mean savings would be between £58 to £85 per severe case treated. If patients with mild-to-moderate asthma were treated with anticholinergics, treatment costs would increase with no clinical benefit. Net savings were estimated to be £437,800 (range –£3,700 to £1,078,100) over five years in England. This was based on the assumption that for every five patients with severe asthma, one with mild-to-moderate asthma would be treated.