title: Comparison of Costs and Clinical Outcomes Between Hospital and Outpatient Administration of Omalizumab in Patients With Severe Uncontrolled Asthma.
abstract: OBJECTIVE
  To compare clinical outcomes and costs between two administration strategies of omalizumab treatment.
  
  
  METHODS
  We evaluated two cohorts of patients with uncontrolled severe asthma over a 1-year period. Patients received the treatment in the primary care center in Hospital A and conventional hospital administration in Hospital B.
  
  
  RESULTS
  We studied 130 patients, 86 in Hospital A and 44 in Hospital B, 30 men (24%) and 100 women (76%), age 50 ± 15 years, FEV1% 67 ± 22%, body mass index (BMI) 28 ± 6 kg/m(2), 639 ± 747 UI IgE/mL, followed for 24 ± 11 months (12-45), Asthma Control Test (ACT) score 12 ± 4 and Asthma Control Questionnaire (ACQ) 3 ± 2. There were no significant pretreatment differences between the groups in hospital admissions and emergency room visits in the previous year, nor in proportion of patients receiving oral steroids. Evaluations were performed at baseline and after 12 months of treatment, revealing significant differences in ACT (P<0.001), ACQ (P<0.001), improvement in FEV1% (P<0.001), reduction in total admissions (P<0.001), days of hospitalization (P<0.001), emergency room visits (P<0.001), cycles and doses of oral steroids (P<0.001) compared to the previous year. Hospitalization costs, emergency room visits, unscheduled visits to primary care and to the pulmonologist were significantly reduced in each hospital and on the whole, but administration and travel costs were 35% lower in the ambulatory strategy adopted in Hospital A.
  
  
  CONCLUSIONS
  The administration of omalizumab in ambulatory health centers achieved the same clinical results as a hospital administration strategy, but with lower costs.
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Alicante, España. Electronic address: echinervives@gmail.com.
authors.forename: Eusebi
authors.initials: E
authors.lastname: Chiner
authors.affiliation: Servicio de Neumología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: Estrella
authors.initials: E
authors.lastname: Fernández-Fabrellas
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Alicante, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Landete
authors.affiliation: Servicio de Neumología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Novella
authors.affiliation: Servicio de Neumología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Ramón
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Alicante, España.
authors.forename: José Norberto
authors.initials: JN
authors.lastname: Sancho-Chust
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Alicante, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Senent
authors.affiliation: Servicio de Neumología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Berraondo
mesh_terms: D000553:Ambulatory Care / Q000191:economics*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000191:economics* / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D018927:Anti-Asthmatic Agents; D000069444:Omalizumab
keywords: Administración ambulatoria; Ambulatory administration; Asma grave no controlada; Costes; Costs; Omalizumab; Uncontrolled severe asthma