Cost-effectiveness analysis of omalizumab in adults and adolescents with moderate-to-severe allergic asthma.
BACKGROUND
Omalizumab can reduce hospitalization and emergency department visits and improve quality of life in patients with moderate-to-severe, suboptimally controlled allergic asthma. Given the high cost and modest efficacy of this agent, it is not clear that it is cost-effective if given to a broad population with asthma.


OBJECTIVE
The purpose of this study was to evaluate the cost-effectiveness of omalizumab in adults and adolescents with moderate-to-severe allergic asthma.


METHODS
A retrospective economic analysis was performed to determine the cost-effectiveness of omalizumab using 52-week data from 2 randomized controlled clinical trials in adults and adolescents with moderate-to-severe allergic asthma. The analysis was conducted from a third-party payer's perspective, and only direct costs were considered.


RESULTS
The incremental cost-effectiveness ratios showed that the cost to achieve an additional successfully controlled day was $523, and the daily cost to achieve at least a 0.5-point increase in Asthma Quality of Life Questionnaire score was $378 in 2003 dollars.


CONCLUSIONS
From a pharmacoeconomic standpoint, omalizumab would be better used in allergic asthmatic patients with poorly controlled symptoms despite maximal therapy, given the high cost and modest efficacy of this agent. It could be cost saving if given to nonsmoking patients who are hospitalized 5 or more times or 20 days or longer per year despite maximal asthma therapy.
Division of Respiratory and Critical Care Medicine, University of Missouri-Kansas City School of Medicine, MO 64108-2792, USA. obay@umkc.edu
Yuji
Y
Oba
Gary A
GA
Salzman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology; D002648:Child; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab; D011788:Quality of Life; D012189:Retrospective Studies
D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab