title: Cost Utility of Omalizumab Compared with Standard of Care for the Treatment of Chronic Spontaneous Urticaria.
abstract: Chronic spontaneous urticaria (CSU) negatively impacts patient quality of life and productivity and is associated with considerable indirect costs to society.
  
  
  
  The aim of this study was to assess the cost utility of add-on omalizumab treatment compared with standard of care (SOC) in moderate or severe CSU patients with inadequate response to SOC, from the UK societal perspective.
  
  
  
  A Markov model was developed, consisting of health states based on Urticaria Activity Score over 7 days (UAS7) and additional states for relapse, spontaneous remission and death. Model cycle length was 4 weeks, and total model time horizon was 20 years in the base case. The model considered early discontinuation of non-responders (response: UAS7 ≤6) and retreatment upon relapse (relapse: UAS7 ≥16) for responders. Clinical and cost inputs were derived from omalizumab trials and published sources, and cost utility was expressed as incremental cost-effectiveness ratios (ICERs). Scenario analyses included no early discontinuation of non-responders and an altered definition of response (UAS7 <16).
  
  
  
  With a deterministic ICER of £3183 in the base case, omalizumab was associated with increased costs and benefits relative to SOC. Probabilistic sensitivity analysis supported this result. Productivity inputs were key model drivers, and individual scenarios without early discontinuation of non-responders and adjusted response definitions had little impact on results. ICERs were generally robust to changes in key model parameters and inputs.
  
  
  
  In this, the first economic evaluation of omalizumab in CSU from a UK societal perspective, omalizumab consistently represented a treatment option with societal benefit for CSU in the UK across a range of scenarios.
authors.affiliation: RTI Health Solutions, Research Triangle Park, NC, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Graham
authors.affiliation: RTI Health Solutions, Manchester, UK.
authors.forename: Doreen
authors.initials: D
authors.lastname: McBride
authors.affiliation: RTI Health Solutions, Research Triangle Park, NC, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Stull
authors.affiliation: Novartis Pharmaceuticals UK Limited, Frimley Business Park, Surrey, UK. anna.halliday@novartis.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Halliday
authors.affiliation: Novartis Pharmaceuticals UK Limited, Frimley Business Park, Surrey, UK.
authors.forename: Stamatia Theodora
authors.initials: ST
authors.lastname: Alexopoulos
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Maria-Magdalena
authors.initials: MM
authors.lastname: Balp
authors.affiliation: Costello Medical Consulting Ltd, Cambridge, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Griffiths
authors.affiliation: Costello Medical Consulting Ltd, Cambridge, UK.
authors.forename: Ion
authors.initials: I
authors.lastname: Agirrezabal
authors.affiliation: Department of Dermatology and Allergy, Allergy-Centre-Charité, Charité-University Hospital Berlin, Berlin, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Zuberbier
authors.affiliation: University of Sheffield, Sheffield, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Brennan
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000191:economics / Q000627:therapeutic use*; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D004526:Efficiency; D006801:Humans; D008390:Markov Chains; D000069444:Omalizumab / Q000191:economics / Q000627:therapeutic use*; D011788:Quality of Life; D012008:Recurrence; D059039:Standard of Care / Q000191:economics; D013997:Time Factors; D006113:United Kingdom; D014581:Urticaria / Q000188:drug therapy* / Q000191:economics
chemical_list: D018926:Anti-Allergic Agents; D000069444:Omalizumab