title: Cost-effectiveness of omalizumab for uncontrolled allergic asthma in the Netherlands.
abstract: BACKGROUND
  Omalizumab, licensed for patients with uncontrolled persistent allergic (IgE mediated) asthma, was found to be cost-effective based upon its clinical trial data. Observational studies have been undertaken to determine the real life outcomes of using omalizumab in the community.
  
  
  OBJECTIVE
  To determine the cost-effectiveness of omalizumab based upon observational data from the Netherlands and compare to its cost-effectiveness using clinical trial data.
  
  
  METHODS
  An observational study (eXpeRience) recruited allergic asthma patients eligible for Omalizumab therapy and followed them while on treatment. At 1 year, data from the Dutch patients enrolled in eXpeRience were examined to estimate the number of exacerbations and resource use while on omalizumab therapy compared to the year prior to omalizumab use. Observational data were used in a Markov model to calculate the lifetime cost-effectiveness ratios.
  
  
  RESULTS
  In the 1 year prior to omalizumab therapy the per-person rate of exacerbations was 3.39 compared to 1.07 in the year taking omalizumab. The discounted incremental lifetime additional costs for omalizumab were €55,865 for 1.46 additional quality-adjusted life years (QALY), resulting in €38,371/QALY. Using the INNOVATE clinical trial outcomes and current resource use, the prior ratio was €34,911/QALY, similar to the observational ratio. As in all observational studies, the main limitation is obtaining complete and accurate data. Patients with missing exacerbation or response data were excluded from this analysis.
  
  
  CONCLUSIONS
  Non-clinical trial experience with omalizumab supported the finding of fewer exacerbations in the allergic asthma population while treated with omalizumab, and therapy was found to continue to have an attractive cost-effectiveness ratio.
authors.affiliation: United BioSource Corporation, London, UK.
authors.forename: Floortje
authors.initials: F
authors.lastname: van Nooten
authors.forename: Sean
authors.initials: S
authors.lastname: Stern
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Braunstahl
authors.forename: Chris
authors.initials: C
authors.lastname: Thompson
authors.forename: Martijn
authors.initials: M
authors.lastname: Groot
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000191:economics* / Q000627:therapeutic use; D000888:Antibodies, Anti-Idiotypic / Q000191:economics* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000191:economics* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D003362:Cost-Benefit Analysis / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D000069444:Omalizumab; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012042:Registries; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab