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


Journal

PharmacoEconomics - open
ISSN: 2509-4254
Titre abrégé: Pharmacoecon Open
Pays: Switzerland
ID NLM: 101700780

Informations de publication

Date de publication:
Sep 2019
Historique:
pubmed: 27 1 2019
medline: 27 1 2019
entrez: 27 1 2019
Statut: ppublish

Résumé

Omalizumab is a fully humanized monoclonal antibody indicated as add-on therapy to improve asthma control in patients with severe persistent allergic asthma. 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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 OBJECTIVE
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 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 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 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.

Identifiants

pubmed: 30684255
doi: 10.1007/s41669-019-0117-4
pii: 10.1007/s41669-019-0117-4
pmc: PMC6710309
doi:

Types de publication

Journal Article

Langues

eng

Pagination

333-342

Références

Thorax. 2001 Apr;56(4):279-84
pubmed: 11254818
J Allergy Clin Immunol. 2003 Jan;111(1):87-90
pubmed: 12532101
Cochrane Database Syst Rev. 2003;(3):CD003559
pubmed: 12917972
Curr Med Res Opin. 2006 Sep;22(9):1765-76
pubmed: 16968580
Allergy. 2007 Feb;62(2):149-53
pubmed: 17298423
Respir Med. 2008 Jan;102(1):71-6
pubmed: 17920257
Allergy. 2008 Jun;63(6):670-84
pubmed: 18445184
Respir Med. 2009 Nov;103(11):1725-31
pubmed: 19515548
J Allergy Clin Immunol. 2009 Oct;124(4):719-23.e1
pubmed: 19767070
Respir Med. 2010 Oct;104(10):1410-6
pubmed: 20483574
Respir Med. 2010 Sep;104(9):1381-5
pubmed: 20599369
Ir J Med Sci. 2011 Sep;180(3):637-41
pubmed: 21557095
Clin Respir J. 2012 Oct;6(4):215-27
pubmed: 21740532
J Asthma. 2012 Feb;49(1):78-82
pubmed: 22149205
Pulm Pharmacol Ther. 2012 Feb;25(1):77-82
pubmed: 22155001
J Asthma. 2012 May;49(4):416-22
pubmed: 22443408
J Asthma. 2012 Oct;49(8):843-8
pubmed: 22954018
J Med Econ. 2013;16(3):342-8
pubmed: 23216016
QJM. 2013 Jul;106(7):631-4
pubmed: 23550166
J Asthma. 2013 Jun;50(5):529-36
pubmed: 23574000
Health Technol Assess. 2013 Nov;17(52):1-342
pubmed: 24267198
Allergol Immunopathol (Madr). 2015 Mar-Apr;43(2):120-6
pubmed: 24780091
World Allergy Organ J. 2014 May 19;7(1):12
pubmed: 24940476
J Asthma. 2015 Mar;52(2):205-10
pubmed: 24995661
Ann Thorac Med. 2014 Oct;9(4):187-92
pubmed: 25276236
Arch Bronconeumol. 2015 May;51(5):235-46
pubmed: 25677358
Int Forum Allergy Rhinol. 2015 Sep;5 Suppl 1:S7-10
pubmed: 26010063
Curr Opin Allergy Clin Immunol. 2015 Oct;15(5):397-401
pubmed: 26226354
Allergy Asthma Proc. 2015 Nov-Dec;36(6):418-24
pubmed: 26534747
Allergy. 2016 May;71(5):593-610
pubmed: 26644231
Clin Drug Investig. 2016 Jul;36(7):567-78
pubmed: 27142072
Int J Mol Sci. 2017 Feb 28;18(3):
pubmed: 28264494
Respir Med. 2017 Mar;124:36-43
pubmed: 28284319
J Med Econ. 2017 Aug;20(8):832-839
pubmed: 28532191
Value Health Reg Issues. 2013 May;2(1):29-36
pubmed: 29702848
Pharmacoeconomics. 2018 Aug;36(8):957-971
pubmed: 29736895
Pharmacoeconomics. 2018 Oct;36(10):1165-1200
pubmed: 29869050

Auteurs

Luis Manuel Entrenas Costa (LM)

Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, Avda. de las Ollerías 1, portal 10 4-2, 14001, Córdoba, Spain. luis.m.entrenas@gmail.com.

Francisco Casas-Maldonado (F)

Unidad de Gestión Clínica de Neumología, Hospital Universitario San Cecilio, Granada, Spain.

José Gregorio Soto Campos (JG)

Unidad de Gestión Clínica de Neumología y Alergia, Hospital de Jerez, Jerez de la Frontera, Cádiz, Spain.

Alicia Padilla-Galo (A)

Agencia Sanitaria Costa del Sol, Unidad de Neumología, Marbella, Málaga, Spain.

Alberto Levy (A)

Hospital Clínico Virgen de la Victoria, Málaga, Spain.

Francisco Javier Álvarez Gutiérrez (FJ)

Unidad de Asma, UMQER, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

Ana P Gómez-Bastero Fernández (AP)

Unidad de Gestión Clínica de Neumología del Hospital Universitario Virgen Macarena, Sevilla, Spain.

Concepción Morales-García (C)

Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain.

Rocío Gallego Domínguez (R)

Sección de Neumología, Complejo Hospitalario Universitario de Cáceres, Cáceres, Spain.

Gustavo Villegas Sánchez (G)

Unidad de Gestión Clínica de Neumología y Alergia, Hospital Torrecárdenas, Almería, Spain.

Luis Mateos Caballero (L)

Sección de Neumología, Hospital de Mérida, Mérida, Spain.

Antonio Pereira-Vega (A)

Unidad de Gestión Clínica de Neumología y Alergia, Hospital Juan Ramón Jiménez, Huelva, Spain.

Cayo García Polo (C)

Unidad de Gestión Clínica de Neumología, Alergia y Cirugía Torácica, Hospital Universitario Puerta del Mar, Cádiz, Spain.

Gerardo Pérez Chica (G)

Unidad de Gestión Clínica de Aparato Respiratorio, Hospital Médico Quirúrgico, Jaén, Spain.

Juan José Martín Villasclaras (JJ)

Unidad Médico Quirúrgica de Enfermedades Respiratorias, Hospital Regional Universitario de Málaga, Málaga, Spain.

Classifications MeSH