Cost Effectiveness of Pharmacological Treatments for Asthma: A Systematic Review

Rodríguez‐Martínez, Carlos E.; Sossa-Briceño, Mónica P; Castro-Rodriguez, José A.

doi:10.1007/s40273-018-0668-8

Cited by 26 publications

(18 citation statements)

References 108 publications

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“…The current review faces similar difficulties in cross‐study comparison as Kim et al does, and it supports the need for standardized data sources and methods. Similar to the general findings of Rodriguez‐Martinez et al, the results of our review also found the quality of the reporting of the study methods to be variable, thus introducing the potential for some uncertainties in several important aspects relating to the methods and relevance of data used.…”

Section: Discussionsupporting

confidence: 83%

“…A few SRs conducted of EE studies for the treatment of childhood asthma were identified. Ungar (2009) only assess pediatric population, while further reviews assessed both adult and pediatric population EEs . The current review aimed to systematically review and critically appraise the literature of EEs that focuses specifically on pediatric asthma and takes a broader view of eligible treatments (both pharmaceutical and non‐pharmaceutical interventions).…”

Section: Introductionmentioning

confidence: 99%

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Economic evaluation of interventions for the treatment of asthma in children: A systematic review

Halmai¹,

Neilson

Kilonzo

2019

Pediatric Allergy Immunology

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Objectives This systematic review aimed to identify and critique full economic evaluations (EEs) of childhood asthma treatments with the intention to guide researchers and commissioners of pediatric asthma services toward potentially cost‐effective strategies. Methods “MEDLINE,” “Embase,” “EconLit,” “NHS EED,” and “CEA” databases were searched to identify relevant EEs published between 2005 and May 2017. Quality of included studies was assessed with a published checklist. Results Eighteen studies were identified and comprised one cost‐benefit analysis, 11 cost‐effectiveness analyses, one cost‐minimization analysis, and six cost‐utility analyses. Treatments included pharmaceutical (n = 11) and non‐pharmaceutical (n = 7) interventions. Fourteen studies identified cost‐effective strategies. The quality of the studies varied and there were uncertainties due to the methods and relevance of data used. Conclusion Good‐quality economic evaluation studies of pediatric asthma treatments are lacking. EE of new technologies adapted to local settings is recommended and can result in cost savings.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Economic evaluation of interventions for the treatment of asthma in children: A systematic review

Halmai¹,

Neilson

Kilonzo

2019

Pediatric Allergy Immunology

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“…Another review of 72 studies assessing the cost‐effectiveness of asthma treatment reported that among patients with uncontrolled severe persistent allergic asthma, omalizumab could be cost‐effective in patients with more severe disease. The quality among studies was uneven and the main cost‐effectiveness drivers were the cost or rate of asthma exacerbations, the cost or rate of use of asthma medication, asthma mortality risk and the rate of utilization of health services for asthma …”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines ‐ recommendations on the use of biologicals in severe asthma

Agache

Rocha

Beltrán

et al. 2020

Allergy

107

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Allergic asthma is a frequent asthma phenotype. Both IgE and type 2 cytokines are increased, with some degree of overlap with other phenotypes. Systematic reviews assessed the efficacy and safety of benralizumab, dupilumab and omalizumab (alphabetical order) vs standard of care for patients with uncontrolled severe allergic asthma. PubMed, Embase and Cochrane Library were searched to identify RCTs and health economic evaluations, published in English. Critical and important asthmarelated outcomes were evaluated. The risk of bias and the certainty of the evidence were assessed using GRADE. All three biologicals reduced with high certainty the annualized asthma exacerbation rate: benralizumab incidence rate ratios (IRR) 0.63 (95% CI 0.50 − 0.81); dupilumab IRR 0.58 (95%CI 0.47 − 0.73); and omalizumab IRR 0.56 (95%CI 0.42 − 0.73). Benralizumab and dupilumab improved asthma control with high certainty and omalizumab with moderate certainty; however, none reached the minimal important difference (MID). Both benralizumab and omalizumab improved QoL with high certainty, but only omalizumab reached the MID. Omalizumab enabled ICS dose reduction with high certainty. Benralizumab and omalizumab showed an increase in drug-related adverse events (AEs) with low to moderate certainty. All three biologicals had moderate certainty for an ICER/QALY value above the willingness to pay threshold. There was high certainty that in children 6-12 years old omalizumab decreased the annualized exacerbation rate [IRR 0.57 (95%CI 0.45-0.72)], improved QoL [relative risk 1.43 (95%CI 1.12 −1.83)], reduced ICS [mean difference (MD) −0.45 (95% CI −0.58 to −0.32)] and rescue medication use [ MD −0.41 (95%CI −0.66 to −0.15)]. K E Y W O R D S benralizumab, dupilumab, exacerbations, omalizumabsevere allergic asthma | 1045 AGACHE Et Al.

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“…Systematic reviews of the cost effectiveness of biologics for the treatment of asthma demonstrated that time horizon and drug price are among the key drivers of the incremental cost-effectiveness ratio 45,46 . Differences in drug prices between countries strongly impact cost effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…Cost-effectiveness analyses of biologics focus on the defined subpopulations of patients with severe disease for whom these treatments are most clinically effective 45,46 . The incremental cost-effectiveness ratio from our analysis of benralizumab of SEK 366,855 (e34,127) is comparable to values reported for use of mepolizumab and reslizumab in the UK, although those values required substantial discounts in UK pricing [22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

Cost effectiveness of benralizumab for severe, uncontrolled oral corticosteroid–dependent asthma in Sweden

Andersson

Janson

Kristensen

et al. 2020

Journal of Medical Economics

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Aim: We investigated cost effectiveness of benralizumab vs. standard of care (SOC) plus oral corticosteroids (OCS) for patients with severe, eosinophilic OCS-dependent asthma in Sweden. Materials and methods: A three-state, cohort-based Markov model of data from three Phase III benralizumab clinical trials (ZONDA [NCT02075255], SIROCCO [NCT01928771], and CALIMA [NCT01914757]) was used to assess the incremental cost-effectiveness ratio of benralizumab vs. SOC plus OCS. Health outcomes were estimated in terms of quality-adjusted life-years (QALYs). The model included costs and disutilities associated with extrapolated OCS-related adverse events. Patients with severe asthma were defined as those receiving OCS !5 mg/day. Results: Benralizumab demonstrated a cost-effectiveness ratio vs. SOC plus OCS of 2018 Swedish Kronor (SEK) 366,855 (e34,127) per QALY gained, based on increases of 1.33 QALYs and SEK 488,742 (e45,344) per patient. Benralizumab treatment costs contributed most to incremental costs. The probability of benralizumab's being cost-effective with willingness-to-pay (WTP) thresholds between SEK 429,972 (e40,000) and SEK 752,452 (e70,000) ranged from 75% to 99%. Limitations: Potential limitations of these analyses include the use of combined data from three different clinical trials, a one-way sensitivity analysis that did not include mortality and transition estimates, and Observational & Pragmatic Research Institute (OPRI) data from the UK as a proxy of the Swedish health care system. Conclusions: The results of these analyses demonstrate that benralizumab has a high probability of being cost-effective compared with SOC plus OCS for a subgroup of patients with severe, eosinophilic asthma receiving regular OCS treatment and may support clinicians, payers and patients in making treatment decisions.

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Cost Effectiveness of Pharmacological Treatments for Asthma: A Systematic Review

Cited by 26 publications

References 108 publications

Economic evaluation of interventions for the treatment of asthma in children: A systematic review

Economic evaluation of interventions for the treatment of asthma in children: A systematic review

Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines ‐ recommendations on the use of biologicals in severe asthma

Cost effectiveness of benralizumab for severe, uncontrolled oral corticosteroid–dependent asthma in Sweden

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