Cost-effectiveness of omalizumab in patients with severe persistent allergic asthma

The health, economic and societal burden of asthma is considerable, and is greatest in patients with severe asthma, particularly when inadequately controlled. Real-life studies that assess the effectiveness of treatment are of particular interest. We determined the incremental cost-effectiveness ratio (ICER) of adding omalizumab to standard therapy using data from the real-life 1-year randomized open-label study (ETOPA) and using Canada as a reference country. Only patients receiving high-dose ICS plus LABA were included in the analysis, reflecting the EU label for omalizumab. Costs and quality-adjusted life years (QALYs) gained were used to calculate the ICER for omalizumab (cost/QALY). Probabilistic sensitivity analysis was performed to determine the 95% confidence interval and one-sided sensitivity analyses were performed. The base case lifetime analysis of standard therapy vs standard therapy plus add-on omalizumab for the first 5 years, gave an ICER of e31 209. Probabilistic sensitivity analysis indicated that the 95% confidence interval around the ICER was e27 739-e40 840. The ICER range for one-way sensitivity analyses was e23 762 without discounting to e66 443 without inclusion of asthma-related mortality. This study demonstrates that add-on omalizumab therapy is cost-effective in patients with severe persistent allergic asthma.