Economic Impact and Clinical Outcomes of Omalizumab Add-On Therapy for Patients with Severe Persistent Asthma: A Real-World Study

Abstract

Background Omalizumab is a fully humanized monoclonal antibody indicated as add-on therapy to improve asthma control in patients with severe persistent allergic asthma. Aims The aim of this study was to evaluate social, healthcare expenditure and clinical outcomes changes after incorporating omalizumab into standard treatment in the control of severe asthma. Methods In this multicentre retrospective study, a total of 220 patients were included from 15 respiratory medicine departments in the regions of Andalusia and Extremadura (Spain). Effectiveness was calculated as a 3-point increase in the Asthma Control Test (ACT) and a reduction in the annual number of exacerbations. The economic evaluation included both direct and indirect costs. Incremental cost-effectiveness ratio (ICER) was calculated. Results from the year before and the year after incorporation of omalizumab were compared. Results After adding omalizumab, improvement of lung function, asthma and rhinitis according to patient perception, as well as the number of exacerbations and asthma control measured by the ACT score were observed. Globally, both healthcare resources and pharmacological costs decreased after omalizumab treatment, excluding omalizumab cost. When only direct costs were considered, the ICER was €1712 (95% CI 1487–1995) per avoided exacerbation and €3859 (95% CI 3327–4418) for every 3-point increase in the ACT score. When both direct and indirect costs were considered, the ICER was €1607 (95% CI 1385–1885) for every avoided exacerbation and €3555 (95% CI 3012–4125) for every 3-point increase. Conclusions Omalizumab was shown to be an effective add-on therapy for patients with persistent severe asthma and allowed reducing key drivers of asthma-related costs.

Economic burden of severe asthma treatment: A real-life study

“…25 Another evaluation of 220 patients from 15 pulmonology departments in Andalusia and Extremadura, also in Spain, found that the mean cost per patient was 12,690.00 EUR one year after starting complementary anti-IgE therapy; the cost-effectiveness per exacerbation avoided was 1712 EUR. 26 Although the average costs per patient are higher than those reported in our study, it is important to consider that patients in the Spanish cohorts had days of hospitalization and visits to the emergency room.…”

Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines ‐ recommendations on the use of biologicals in severe asthma

“…After screening 1884 hits and reviewing 36 full text articles, 22 economic evaluations were included (Figure 2, Table ). Two studies evaluated benralizumab, one dupilumab and twenty studies omalizumab (Table ). Most of the studies excluded did not evaluate patients with allergic asthma (3/14), did not report health outcomes (3/14) or were conference abstracts (3/14) (Table ).…”

Cost‐effectiveness of omalizumab for the treatment of severe pediatric allergic asthma—Results of a real‐life study in Spain

“…We have no data in children for comparison, but in two studies in adult patients in our country, the ICER varied from €1488 to €1712 euros per avoided MSE with the same criteria we used. 29,30 When these studies included indirect costs, not available in our patients, the figures decreased to €1130 and €1607 euros, reductions of 24% and 6%, respectively. In two studies in adults, the figures per avoided exacerbation were €1789 and €2244 euros, including indirect costs.…”

“…In the first year of treatment of our patients the mean ICER to avoid an MSE (main objective of this report) was €2107 euros (median €998). We have no data in children for comparison, but in two studies in adult patients in our country, the ICER varied from €1488 to €1712 euros per avoided MSE with the same criteria we used 29,30 . When these studies included indirect costs, not available in our patients, the figures decreased to €1130 and €1607 euros, reductions of 24% and 6%, respectively.…”