AFFORDABILITY OF BIOLOGIC ADD-ON THERAPY FOR SEVERE EOSINOPHILIC ASTHMA IN THAILAND: A BUDGET IMPACT ANALYSIS OF MEPOLIZUMAB AND BENRALIZUMAB...
Author(s)
Najmee Adulyarat, PharmD1, Watchara Boonsawat, MD,PhD2, Piyameth Dilokthornsakul, PharmD, PhD3.
1Walailak University, Nakhonsrithammarat, Thailand, 2Khon Kaen University, Khon Kaen, Thailand, 3Center for Medical and Health Technology Assessment (CM-HTA), Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.
1Walailak University, Nakhonsrithammarat, Thailand, 2Khon Kaen University, Khon Kaen, Thailand, 3Center for Medical and Health Technology Assessment (CM-HTA), Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.
OBJECTIVES: To estimate the five-year budget impact of introducing mepolizumab and benralizumab as add-on biologic therapies for patients with uncontrolled severe eosinophilic asthma in Thailand from the payer perspective.
METHODS: A model-based budget impact analysis was constructed in Microsoft Excel over a five-year time horizon, following ISPOR Budget Impact Analysis Good Practice guidelines. The standard of care (current scenario) was compared with new scenarios which were add-on mepolizumab or benralizumab to standard of care. Biologic treatments were modeled for a maximum of two years per patient with annual mortality adjustment. Scenario and one-way sensitivity analyses examined uncertainty in eligible population size, uptake rates, epidemiological parameters, and drug acquisition costs.
RESULTS: The five-year total cost of standard of care was THB 160.43 million (USD 4.90 million). Introducing mepolizumab or benralizumab increased total costs to THB 1,709.56 million (USD 52.20 million) and THB 1,708.40 million (USD 52.16 million), respectively. A total five-year net budget impacts (NBI) were THB 1,549.13 million (USD 47.30 million) for mepolizumab and THB 1,547.96 million (USD 47.26 million) for benralizumab, with the average annual NBI of THB 309.83 million and THB 309.59 million. Results were most sensitive to biologic uptake rate, eligible population size, and drug acquisition cost. Price reductions of 50% approximately halved the projected budget impact.
CONCLUSIONS: Introducing mepolizumab or benralizumab for uncontrolled severe eosinophilic asthma would substantially increase public healthcare expenditure in Thailand, with simialr budget impacts between the two biologics. Price negotiation and eligibility criteria design could be considered for managing affordability within Thailand healthcare financial system.
METHODS: A model-based budget impact analysis was constructed in Microsoft Excel over a five-year time horizon, following ISPOR Budget Impact Analysis Good Practice guidelines. The standard of care (current scenario) was compared with new scenarios which were add-on mepolizumab or benralizumab to standard of care. Biologic treatments were modeled for a maximum of two years per patient with annual mortality adjustment. Scenario and one-way sensitivity analyses examined uncertainty in eligible population size, uptake rates, epidemiological parameters, and drug acquisition costs.
RESULTS: The five-year total cost of standard of care was THB 160.43 million (USD 4.90 million). Introducing mepolizumab or benralizumab increased total costs to THB 1,709.56 million (USD 52.20 million) and THB 1,708.40 million (USD 52.16 million), respectively. A total five-year net budget impacts (NBI) were THB 1,549.13 million (USD 47.30 million) for mepolizumab and THB 1,547.96 million (USD 47.26 million) for benralizumab, with the average annual NBI of THB 309.83 million and THB 309.59 million. Results were most sensitive to biologic uptake rate, eligible population size, and drug acquisition cost. Price reductions of 50% approximately halved the projected budget impact.
CONCLUSIONS: Introducing mepolizumab or benralizumab for uncontrolled severe eosinophilic asthma would substantially increase public healthcare expenditure in Thailand, with simialr budget impacts between the two biologics. Price negotiation and eligibility criteria design could be considered for managing affordability within Thailand healthcare financial system.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE28
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), STA: Biologics & Biosimilars