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J Allergy Clin Immunol. 2007 Nov;120(5):1146-52. Epub 2007 Sep 29.

Cost-effectiveness of omalizumab in adults with severe asthma: results from the Asthma Policy Model.

Author information

1
Department of Ambulatory Care and Prevention, Harvard Medical School and Children's Hospital, Boston, MA 02215-5301, USA. ann.wu@childrens.harvard.edu

Abstract

BACKGROUND:

Omalizumab (trade name Xolair) is approved by the US Food and Drug Administration for treatment of moderate-to-severe allergic asthma. Given the high acquisition cost of omalizumab, its role and cost-effectiveness in disease management require definition.

OBJECTIVE:

We sought to identify the clinical and economic circumstances under which omalizumab might or might not be a cost-effective option by using a mathematic model.

METHODS:

We merged published data on clinical and economic outcomes (including acute event incidence, frequency/severity of hospitalizations, and health-related quality of life) to project 10-year costs, quality-adjusted life years (QALYs), and cost-effectiveness of treatment with omalizumab in addition to inhaled corticosteroids. Sensitivity analyses were conducted by using input data ranges from a variety of sources (published clinical trials and observational databases).

RESULTS:

For patients with baseline acute event rates, omalizumab conferred an additional 1.7 quality-adjusted months at an incremental cost of $131,000 over a 10-year planning horizon, implying a cost-effectiveness ratio of $821,000 per QALY gained. For patients with 5 times the baseline acute event rate, the cost-effectiveness ratio was $491,000 per QALY gained. The projected cost-effectiveness ratio could fall within a range of other programs that are widely considered to be cost-effective if the cost of omalizumab decreases to less than $200.

CONCLUSION:

Omalizumab is not cost-effective for most patients with severe asthma. The projected cost-effectiveness ratios could fall within a favorable range if the cost of omalizumab decreases significantly.

CLINICAL IMPLICATIONS:

Based on the high cost of omalizumab, it is especially important that clinicians explore alternative medications for asthma before initiating omalizumab.

Comment in

PMID:
17904628
PMCID:
PMC3476046
DOI:
10.1016/j.jaci.2007.07.055
[Indexed for MEDLINE]
Free PMC Article

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