Estimation of Health and Economic Benefits of Clinic Versus Home Administration of Omalizumab and Mepolizumab

COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic

“…If this is not available or possible, then in-office initiation can occur, preferably with a maximum of 1-2 visits and then transition to home administration in the overwhelming majority of cases, unless there are unusual circumstances or if this is not feasible. 50 Although omalizumab has been approved in Europe for home administration after uneventful administration of 4 doses in clinic, currently home administration of omalizumab in the United States would represent a departure from usual care, and, as such, risks and benefits should be clearly discussed and informed consent documented. 44,45 7) For patients on maintenance doses of biologics, consider converting the patient to a prefilled syringe for potential home administration if this is available (home administration was recently shown to be safe and cost-effective for antieIL-5 and anti-IgE therapy 50 ), vs the risk/benefit of missing 1 or several doses.…”

“…50 Although omalizumab has been approved in Europe for home administration after uneventful administration of 4 doses in clinic, currently home administration of omalizumab in the United States would represent a departure from usual care, and, as such, risks and benefits should be clearly discussed and informed consent documented. 44,45 7) For patients on maintenance doses of biologics, consider converting the patient to a prefilled syringe for potential home administration if this is available (home administration was recently shown to be safe and cost-effective for antieIL-5 and anti-IgE therapy 50 ), vs the risk/benefit of missing 1 or several doses. However, some patients may need to be seen face-to-face for biologic administration, which underscores the need for resource prioritization as outlined above.…”

Pediatric asthma and COVID‐19: The known, the unknown, and the controversial

“…The American Academy of Allergy, Asthma and Immunology notes no evidence that immune response to COVID‐19 will be impaired in patients with asthma on biologic therapies and that it would be “reasonable” to continue administration of biologics in patients with asthma, 37,38 a recommendation supported by several international allergy/pulmonology organizations including the British Thoracic Society, and the Italian Society of Allergy, Asthma and Clinical Immunology 39,40 . These organizations also support home‐based administration of biologics when possible, an approach that improves access and is cost‐effective 38,41,42 …”

Health and Economic Outcomes of Home Maintenance Allergen Immunotherapy in Select Patients with High Health Literacy during the COVID-19 Pandemic: A Cost-Effectiveness Analysis During Exceptional Times

“…Provided education is appropriate, there is every reason to think that 12 maintenance injections could be handled as such in a pandemic setting, in select patients. To contextualize risk, the estimated rate of AIT fatality per injection, 1.3 Â 10 À7 , is on par with the estimated risks of fatal penicillin anaphylaxis (8.0 Â 10 À8 ), 46 per-patient omalizumab fatality (5.8 Â 10 À6 ), 42,47,48 and the general population risk of homepeanut introduction in US infants (0.3-3 Â 10 À7 ) 49 (see Figure E4 in this article's Online Repository at www.jaciinpractice.org). Penicillin is administered without mandated routine medical observation in the general population, omalizumab is approved for preference-sensitive home administration after the first 4 uneventful doses in Europe at provider discretion for patients with appropriate indication, and young infants routinely have peanut introduced at home.…”