The economic value of anti-IgE in severe persistent, IgE-mediated (allergic) asthma patients:adaptation of INNOVATE to Sweden

Dewilde, Sarah; Turk, Florian; Tambour, Magnus; Sandström, Thomas

doi:10.1185/030079906x132389

Cited by 78 publications

(75 citation statements)

References 30 publications

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“…Indeed, cost-effectiveness analyses of omalizumab that accounted for responder status have shown that omalizumab is cost-effective in patients with severe persistent allergic asthma. 73,74 One analysis 73 applied data from the INNOVATE 49 study to Sweden as a reference country and calculated an incremental cost-effectiveness ratio (ICER) of €56,091, slightly higher than the Swedish accepted threshold of €53,384 (SEK 500,000). The annual cost of treatment with omalizumab, based on the dose distributions observed in INNOVATE was calculated to be €15,444.…”

Section: Cost-effectivenessmentioning

confidence: 99%

The use of omalizumab in asthma

Price

2008

Primary Care Respiratory Journal

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Asthma causes a substantial burden of morbidity and mortality, affecting 300 million people worldwide -a figure predicted to increase to 400 million by 2025. Despite the availability of a variety of treatment options and detailed treatment guidelines, many patients with asthma, and in particular those with severe persistent asthma, remain inadequately controlled. Approximately 50-80% of severe asthma has an allergic component, with immunoglobulin E (IgE) playing a role in the underlying allergic inflammatory cascade. Omalizumab is a humanised monoclonal anti-IgE antibody that targets IgE and partially inhibits the inflammatory cascade. Clinical trials have demonstrated that omalizumab added to standard asthma therapy reduces exacerbations and emergency visits with concomitant improvements in asthma control and quality of life in patients with moderate-to-severe and severe persistent allergic (IgE-mediated) asthma. Add-on omalizumab is indicated for the treatment of patients with inadequately controlled moderate-to-severe (US label) and severe (EU label) persistent allergic asthma despite treatment with high-dose inhaled corticosteroids (and in the EU, high-dose inhaled corticosteroids plus a long-acting β2-agonist). Within this highly-targeted patient population, analyses have been unable to identify pre-treatment clinical characteristics that are predictive of a greater response to omalizumab. In contrast, assessment of response to omalizumab following 16 weeks of treatment appears to be reliably judged by physicians in clinical trial settings and may be a feasible means of selecting patients who should continue treatment.

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Section: Cost-effectivenessmentioning

confidence: 99%

The use of omalizumab in asthma

Price

2008

Primary Care Respiratory Journal

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“…The authors found that the ICER for omalizumab ranged between J27,739 and J40,840. This range was considerably lower than the ICER calculated by DEWILDE et al [66] and would suggest that omalizumab is cost-effective as an add-on therapy in patients with severe persistent asthma.…”

Section: Costs Associated With Omalizumabmentioning

confidence: 55%

“…DEWILDE et al [66] performed an economic evaluation of omalizumab, which was based on the data from the INNOVATE trial [41]. They found the incremental cost-effectiveness ratio (ICER), which is the difference in total costs between two treatment arms per quality-adjusted life year, for omalizumab as an add-on therapy to be J56,091.…”

Section: Costs Associated With Omalizumabmentioning

confidence: 99%

Omalizumab: an anti-immunoglobulin E antibody for the treatment of allergic respiratory diseases

Bousquet¹,

Wahn²,

Meltzer³

et al. 2008

European Respiratory Review

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Immunoglobulin E (IgE) is central to the development of allergic diseases. Crosslinking of cell-bound IgE by the allergen leads to the initiation of the inflammatory cascade. Omalizumab, an anti-IgE antibody, forms complexes with free IgE, thereby inhibiting the allergic reaction before its commencement.A survey of the clinical trials performed on omalizumab indicated that this anti-IgE antibody is efficacious and well tolerated in the treatment of separate and concomitant asthma and rhinitis. In patients with poorly controlled asthma, omalizumab reduced the asthma exacerbation and emergency visit rate, along with improving the quality of life. The improvement in asthma control was associated with a reduction of inhaled and oral corticosteroids. Improved nasal symptom scores and a reduced need for antihistamines were observed in patients with allergic rhinitis. Omalizumab was also proven to be effective as an add-on therapy for concomitant asthma and rhinitis.In conclusion, omalizumab provides an integrated approach for the treatment and management of allergic respiratory diseases.

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“…Eight studies compared monotherapy vs monotherapy (38,41,42,45,46,51,56,58). Four studies compared add-on omalizumab vs usual care (39,47,57,60). There was one study over the time period that considered the costs of reliever therapies, but since no health outcome was reported this study was excluded (62).…”

Section: Literature Search Resultsmentioning

confidence: 99%

Health economics of asthma: assessing the value of asthma interventions

Campbell

Spackman

Sullivan

2008

Allergy

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The aim of this systematic review was to summarize and assess the quality of asthma intervention health economic studies from 2002 to 2007, compare the study findings with clinical management guidelines, and suggest avenues for future improvement of asthma health economic studies. Forty of the 177 studies met our inclusion criteria. We assessed the quality of studies using The Quality of Health Economic Studies validated instrument (total score range: 0–100). Six studies (15%) had quality category 2, 26 studies (65%) achieved quality category 3, and the remaining eight (20%) studies were scored as the highest quality level, category 4. Overall, the findings from this review are in line with the Global Initiative for Asthma clinical guidelines. Many asthma health economic studies lacked appropriate long term time horizons to match the chronic nature of the disease and suffered from using effectiveness measures that did not capture all disease related risks and benefits. We recommend that new asthma simulation models: be flexible to allow for long term time horizons, focus on using levels of asthma control in their structure, and estimate both long term asthma specific outcomes like well‐controlled time as well as generic outcomes such as quality adjusted survival.

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The economic value of anti-IgE in severe persistent, IgE-mediated (allergic) asthma patients:adaptation of INNOVATE to Sweden

Abstract: Based on the model and the assumptions used, our results suggest that omalizumab provides cost offsets, improves quality of life and may have an attractive ICER in treating the severe allergic asthma population.

Cited by 78 publications

References 30 publications

The use of omalizumab in asthma

The use of omalizumab in asthma

Omalizumab: an anti-immunoglobulin E antibody for the treatment of allergic respiratory diseases

Health economics of asthma: assessing the value of asthma interventions

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