薬経済学: オープンアクセス

Economic Evaluation of Omalizumab in the Treatment of Severe AllergicAsthma in Adult Patients in Greece: A Cost Effectiveness Analysis ofClinical Trial and Real-Life Data

Abstract

Venkateshwarlu Sonathi, Magdalini Hatzikou, Mary Geitona, Mike Baldwin, Elena Panitti and Nikolaos Siafakas

Background: Severe asthma is a major cause of morbidity and mortality around the world, associated with a heavy societal burden. The aim of this study was to evaluate the economic value of omalizumab in the treatment of adult patients with severe asthma in Greece, from a societal perspective, based on both data collected via a clinical trial and data from a prospective observational study with real-world evidence (RWE) using a simulation model.
Method: A Markov cohort model was developed in Microsoft Excel to compare the costs and outcomes of omalizumab plus standard therapy (ST) versus ST alone. The time horizon was that of a lifetime. Costs and health outcomes were discounted annually at 3.5%. A primary analysis was based on clinical data from the INNOVATE trial, and a secondary analysis, was based on recently published real-world evidence on effectiveness of omalizumab. Both direct and indirect costs were incorporated. Unit costs were taken from publically available sources, Productivity losses were calculated based on published data, while utility values were taken from the INNOVATE study. Deterministic and probabilistic sensitivity analyses were undertaken to test the robustness of the model results.
Results: The addition of omalizumab to ST led to an incremental cost of €27,888 and € 27,255 per QALY gained in the primary and secondary analyses, respectively. The model appeared to be most sensitive to changes in the time horizon and the age of retirement. The results of the probabilistic sensitivity analysis showed that the probability of omalizumab being cost effective was 58% and 84%, at a threshold of €30,000 and € 40,000 (willingness to pay for one QALY), respectively.
Conclusion: Omalizumab appears to be a cost-effective treatment option for patients with severe asthma compared to ST in Greece, and this result is confirmed both with trial and real-world data.