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

Ann C. Wu, A. David Paltiel, Karen M. Kuntz, Scott T. Weiss, Anne L. Fuhlbrigge

Research output: Contribution to journalArticlepeer-review

88 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1146-1152
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Volume120
Issue number5
DOIs
StatePublished - Nov 2007

Keywords

  • Omalizumab
  • anti-IgE
  • asthma
  • cost-effectiveness

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