<p>Omalizumab for Severe Allergic Asthma Treatment in Italy: A Cost-Effectiveness Analysis from PROXIMA Study</p>

Abstract

Introduction: Inadequately controlled severe asthma patients require additional therapy accounting for significant clinical and economic burden. Our analysis aims to determine the cost-effectiveness of omalizumab in the management of severe allergic asthma in Italy based on observational data from the PROXIMA study. Methods: Observational data on efficacy, healthcare resource utilization and changes in quality of life at 12 months after the initiation of omalizumab were examined to estimate the cost-effectiveness compared to pre-omalizumab period and results were expressed with Incremental Cost-Effectiveness Ratio (ICER). The cost-utility analysis estimated the cost per quality-adjusted life-year (QALY) gained. Direct health costs were assessed from the perspective of the Italian National Health Service (NHS). Results: Omalizumab reduced the incidence of exacerbations, number of hospitalizations, physician visits, and improved quality of life after 12 months of treatment. Omalizumab had a greater effectiveness than pre-omalizumab treatment involving 0.132 QALYs gained and led to a €3729 per patient reduction in direct healthcare costs, excluding the add-on treatment cost. Nevertheless, the addition of omalizumab cost led to €7478 increase in total direct costs with respect to preomalizumab period. Based on difference in total direct cost and difference in QALY between post and pre-omalizumab period, the ICER was €56,847. According to sensitivity analysis, omalizumab provided a cost-effective use of NHS resources, already at 20% discounted price. Conclusion: This study offers a real-world evidence of omalizumab effectiveness in Italy. Despite the high acquisition cost of the innovative drug, omalizumab is a sustainable treatment option for patients with uncontrolled severe allergic asthma.

Use of corticosteroids in asthma and COPD patients with or without COVID-19

“…On the other hand, the minority of patients with severe allergic asthma who are receiving maintenance OCS should be titrated to the lowest possible dose sufficient to maintain symptoms. These patients should be supported with the corticosteroid-sparing effects of the biological drug, omalizumab [34], which could reduce the risk of adverse events from OCS use including increased risk of respiratory infection and thus a potential reduction in healthcare costs. Similarly, other biologicals such as mepolizumab [35] and benralizumab [36] have a corticosteroid-sparing effect and may be considered in patients with severe eosinophilic asthma receiving maintenance OCS.…”

Switching from one biologic to benralizumab in patients with severe eosinophilic asthma: An ANANKE study post hoc analysis

“…Severe asthma is a complex and heterogeneous disease that affects 5-10% of patients with asthma (1), and is characterized by the presence of severe exacerbations, systemic corticosteroid use and costs related to healthcare resource utilization (2).…”

Cost-Effectiveness of Omalizumab for the Treatment of Severe Pediatric Allergic Asthma- Results of a Real-Life Study in Spain

“…(33) The costs for studies in the USA show very high figures, from US$75,319 (34) to US$821,000 (35) per QALY, whereas in the study in children, in China, that cost was calculated also as high as US$211,217. ( 45) (33) The cost was much lower in Europe, \euro56,847 in Italy (36) and that a cost of \euro30,000 to \euro45,000 per QALY would be an affordable price in Spain. (37) We have no data about quality of life in our patients, so we can only speculate that at least the cost for QALY would decrease in successive years, given the reduction of costs in the variables we evaluated.…”