Comparative effectiveness of budesonide inhalation suspension and montelukast in children with mild asthma in Korea

<b>Objective:</b> The comparative effectiveness of low-dose budesonide inhalation suspension (BIS) versus oral montelukast (MON) in managing asthma control among children with mild asthma was assessed in Korea. <b>Methods:</b> Claims from Korea’s national health insurance database for children (2–17 years) with mild asthma (GINA 1 or 2) who initiated BIS or MON during 2015 were retrospectively analyzed. Pre- and post-index windows were 1 year each. Adherence, persistency, asthma control, asthma-related health-care resource utilization, and costs were evaluated using unadjusted descriptive statistics and propensity score-matched regression analyses. <b>Results:</b> The number of children identified was 26,052 for unmatched (<i>n</i> = 1,221 BIS; <i>n</i> = 24,831 MON) and 2,290 for matched populations (<i>n</i> = 1,145 per cohort). Medication adherence, measured by proportion of days covered, was low for both cohorts but significantly higher for MON versus BIS (13.8% vs. 4.5%; <i>p</i> p p p p p <b>Conclusions:</b> Montelukast patients had better adherence, a longer time to loss of persistency, and were less likely to experience an exacerbation-related office visit in the post-index period than BIS patients.