title: Cost-effectiveness of omalizumab in severe persistent asthma in Spain: a real-life perspective.
abstract: OBJECTIVE
  To determine the cost-effectiveness of omalizumab compared with routine clinical practice in the treatment and control of severe persistent asthma.
  
  
  METHODS
  Cost-effectiveness analysis using pre- and post-treatment with omalizumab after 10 months of 47 patients diagnosed with uncontrolled severe persistent asthma attended by the Pneumology Service, Hospital Universitario Virgen de la Victoria, Malaga. Effectiveness was assessed by the number of emergency room (ER) visits for exacerbations and quality-adjusted life years (QALY) gained. The costs of treatment with omalizumab and ER visits were analyzed using the National Health System perspective. Results are expressed in cost per QALY gained and cost per ER visit avoided (costs €2012).
  
  
  RESULTS
  Exacerbations with ER visits decreased significantly (p < 0.001) after 10 months of omalizumab treatment compared with the previous 10 months [7.94 (6.52-9.37) vs 0.19 (0.03-0.35)]. Health utilities increased significantly (p < 0.001) during the same period [0.5967 (0.5722-0.6212) vs 0.7566 (0.7232-0.7900)], representing 0.1333 (0.1053-0.1612) QALYs gained (p < 0.001).The mean cost per patient was €1850.78 (1519.46-2182.10) in the 10 months before treatment and €5431.87 (4930.72-5933.02) after 10 months of omalizumab treatment. The incremental cost-effectiveness ratios (ICERs) were €462.08/exacerbation avoided (347.65-606.22) and €26 864.89/QALY gained (21 632.07-33 859.49).
  
  
  CONCLUSIONS
  Our results confirm that adding omalizumab to the treatment of patients with uncontrolled severe persistent asthma reduces the number of exacerbations with ER visits and increases health-related quality of life after 10 months of treatment and produces ICERs favorable to omalizumab and acceptable from the health system perspective.
authors.affiliation: Servicio de Neumología, Hospital Universitario Virgen de la Victoria , Málaga , Spain and.
authors.forename: Alberto Nahon
authors.initials: AN
authors.lastname: Levy
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: García A Ruiz
authors.forename: Nuria
authors.initials: N
authors.lastname: García-Agua Soler
authors.forename: María Victoria Hidalgo
authors.initials: MV
authors.lastname: Sanjuan
mesh_terms: 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; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013030:Spain
chemical_list: D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab
keywords: Asthma; cost-utility; effectiveness; healthcare costs; omalizumab