Cost-effectiveness of personalized omalizumab dosing for chronic spontaneous urticaria

Abstract

The licensed dose for omalizumab within Europe for chronic spontaneous urticaria (CSU) is 300 mg every 4 weeks, and is based on the most effective dose identified in clinical trials. However, many patients require longer‐term treatment with omalizumab and there is limited guidance on how to manage these patients. We report on a large cohort of 357 patients with CSU who have been treated over a 10‐year period on a personalized dosing regimen. Our results showed a 4% reduction in drug cost for this personalized dosing regimen compared with having all patients on the standard regimen of omalizumab 300 mg every 4 weeks. In addition, by increasing the dose, we were able to treat 22% of patients more effectively, using the principle aim of zero CSU symptoms; prior to this regimen, these patients had been achieving only partial response. Omalizumab doses and frequency should be adjusted depending on clinical response to allow for improved benefits for both patients and healthcare systems.

Psychosocial factors and chronic spontaneous urticaria: a systematic review

“…The first line treatment for CSU is antihistamines at licenced doses. For patients with symptoms that are refractory to high dose antihistamines, treatment is advanced to include the anti-IgE monoclonal antibody omalizumab and cyclosporine [ 1 ]; creating a financial burden on healthcare systems, with a variable success rate for disease management [ 4 ]. Whilst disease management of chronic urticaria phenotypes is similar, grouping both CSU and CIndU under a chronic urticaria phenotype may obscure important contributors related to these conditions, especially in relation to psychosocial factors.…”