ECONOMIC EVALUATION OF MEPOLIZUMAB AND BENRALIZUMAB FOR ADULTS WITH SEVERE EOSINOPHILIC ASTHMA IN THAILAND
Author(s)
Khachen Kongpakwattana, PhD1, Watchara Boonsawat, MD,PhD2, Tammanoon Iemsupap, PharmD3, Piyameth Dilokthornsakul, PharmD, PhD3.
1Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 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.
1Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 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: Severe eosinophilic asthma is a debilitating condition that impacts patients’ quality of life and imposes economic burden on healthcare systems. Evidence shows the efficacy and safety of biologics for severe eosinophilic asthma (SEA); however, their current market prices could limit patients’ access, especially in resource-limited countries. Economic evidence is needed to determine the value for money of the biologics. This study aimed to evaluate the cost-utility of mepolizumab and benralizumab for adult patients with SEA in Thailand.
METHODS: A state-transition Markov model was conducted from a societal perspective with a lifetime horizon. The interventions of interest were mepolizumab and benralizumab in addition to the standard of care (SoC) for uncontrolled SEA adults. A comprehensive literature review was conducted to determine inputs informing the model. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated to evaluate the cost-effectiveness of the biologics compared to SoC alone. The 3% discount rate was applied. The willingness-to-pay (WTP) of 160,000 THB/QALY (4,903 $/QALY) was used as a cost-effectiveness threshold.
RESULTS: Compared to SoC alone, mepolizumab, in addition to SoC at its current price, had an incremental lifetime cost of 308,240 Thai baht (THB) ($9,446) with an incremental QALY of 0.43, resulting in the ICER of 711,787 THB/QALY (21,813 $/QALY). For benralizumab, an incremental lifetime cost was 164,446 THB ($5,040) and an incremental QALY was 0.08. The ICER for benralizumab was 2,141,023 THB/QALY (65,613 $/QALY). Our threshold analysis suggested reducing approximately 39.1% of the mepolizumab price and 31.9% of the benralizumab price to reach the WTP threshold.
CONCLUSIONS: At their current prices, both mepolizumab and benralizumab are not cost-effective for adult patients with SEA. The Thai government might need to consider price negotiation or other purchasing strategies to reduce the biologic prices to make them cost-effective from a societal perspective.
METHODS: A state-transition Markov model was conducted from a societal perspective with a lifetime horizon. The interventions of interest were mepolizumab and benralizumab in addition to the standard of care (SoC) for uncontrolled SEA adults. A comprehensive literature review was conducted to determine inputs informing the model. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated to evaluate the cost-effectiveness of the biologics compared to SoC alone. The 3% discount rate was applied. The willingness-to-pay (WTP) of 160,000 THB/QALY (4,903 $/QALY) was used as a cost-effectiveness threshold.
RESULTS: Compared to SoC alone, mepolizumab, in addition to SoC at its current price, had an incremental lifetime cost of 308,240 Thai baht (THB) ($9,446) with an incremental QALY of 0.43, resulting in the ICER of 711,787 THB/QALY (21,813 $/QALY). For benralizumab, an incremental lifetime cost was 164,446 THB ($5,040) and an incremental QALY was 0.08. The ICER for benralizumab was 2,141,023 THB/QALY (65,613 $/QALY). Our threshold analysis suggested reducing approximately 39.1% of the mepolizumab price and 31.9% of the benralizumab price to reach the WTP threshold.
CONCLUSIONS: At their current prices, both mepolizumab and benralizumab are not cost-effective for adult patients with SEA. The Thai government might need to consider price negotiation or other purchasing strategies to reduce the biologic prices to make them cost-effective from a societal perspective.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE67
Topic
Economic Evaluation
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), STA: Biologics & Biosimilars