The Editors Respond: The Diminishing Role of Montelukast in Asthma Therapy

We greatly appreciate the additional opportunity to examine the therapeutic value of montelukast in particular and the leukotriene modifiers in general. The true value for money spent on montelukast is a subject of interest to virtually every managed care clinician and administrative pharmacist, as montelukast generated $2.976 billion in worldwide sales for the manufacturer in 2005, up 13.5% from $2.622 billion in 2004. Montelukast was cited in the company's 2005 annual report as the leader in sales performance, among its portfolio of products, and montelukast is projected to be the leading product in sales for the manufacturer through 2009. Montelukast costs about $1,100 per patient per year at discounted managed care organization prices in the United States in 2006; in the 3 months ending May 31, 2006, it pushed its way to be the overall fourth-highest expenditure drug. Any potentially negative information about montelukast would understandably be of great concern to the manufacturer and its employees.