Cost-Effectiveness Analysis of Health Care Interventions in Patients with Chronic Rhinosinusitis with Nasal Polyps: A Systematic Literature Review
Author(s)
Sumeet Attri, M Pharm1, Barinder Singh, RPh2, Ritesh Dubey, PharmD1, Gagandeep Kaur, M Pharm1, Pankaj Rai, MS Pharm1.
1Pharmacoevidence, SAS Nagar Mohali, India, 2Pharmacoevidence, London, United Kingdom.
1Pharmacoevidence, SAS Nagar Mohali, India, 2Pharmacoevidence, London, United Kingdom.
Presentation Documents
OBJECTIVES: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory disease affecting the sinuses and nasal cavity. Economic evaluation (EE) and health technology assessments (HTAs) are crucial in informing healthcare decisions. This study aimed to determine the cost-effectiveness of healthcare interventions in adult patients with CRSwNP.
METHODS: Key biomedical databases (Embase® and PubMed®) and global HTAs were searched from database inception to December 2024 to identify relevant published EEs evaluating adult patients with CRSwNP. Two independent reviewers carried out screening and data collection, with a third reviewer performing a quality check in line with PRISMA guidelines.
RESULTS: A total of 13 studies (12 EE [seven cost-utility and five cost-effectiveness studies and one HTA] were included. The studies evaluated various biologics (dupilumab, omalizumab, mepolizumab) and surgical interventions (elective sinus surgery [ESS], ESS + endoscopic frontal sinusotomy, endoscopic polypectomy in clinic [EPIC]), conducted from the perspective of third-party payers in the US (7), Canada (4), Colombia (1), and Italy (1). The time horizons across studies ranged from 5 to 36 years, with a few adopting a lifetime perspective. Cycle lengths varied between 6 and 24 months, while discount rates ranged from 1.5% to 5%. Across studies, omalizumab was found to be cost-effective compared to other biologics. When surgeries were compared to biologics or medical therapy, ESS was found to be cost-effective in six studies. Among different surgical options, EPIC was a cost-effective option compared to ESS ± endoscopic frontal sinusotomy. Furthermore, a Canadian HTA revealed that mepolizumab combined with standard of care was not cost-effective at a willingness-to-pay threshold of $50,000 per QALY when compared to standard of care alone.
CONCLUSIONS: Overall, both biologics, particularly omalizumab, and ESS are cost-effective treatments for CRSwNP. However, mepolizumab combined with standard care was not cost-effective in Canada. Further comprehensive analyses are required to confirm these results.
METHODS: Key biomedical databases (Embase® and PubMed®) and global HTAs were searched from database inception to December 2024 to identify relevant published EEs evaluating adult patients with CRSwNP. Two independent reviewers carried out screening and data collection, with a third reviewer performing a quality check in line with PRISMA guidelines.
RESULTS: A total of 13 studies (12 EE [seven cost-utility and five cost-effectiveness studies and one HTA] were included. The studies evaluated various biologics (dupilumab, omalizumab, mepolizumab) and surgical interventions (elective sinus surgery [ESS], ESS + endoscopic frontal sinusotomy, endoscopic polypectomy in clinic [EPIC]), conducted from the perspective of third-party payers in the US (7), Canada (4), Colombia (1), and Italy (1). The time horizons across studies ranged from 5 to 36 years, with a few adopting a lifetime perspective. Cycle lengths varied between 6 and 24 months, while discount rates ranged from 1.5% to 5%. Across studies, omalizumab was found to be cost-effective compared to other biologics. When surgeries were compared to biologics or medical therapy, ESS was found to be cost-effective in six studies. Among different surgical options, EPIC was a cost-effective option compared to ESS ± endoscopic frontal sinusotomy. Furthermore, a Canadian HTA revealed that mepolizumab combined with standard of care was not cost-effective at a willingness-to-pay threshold of $50,000 per QALY when compared to standard of care alone.
CONCLUSIONS: Overall, both biologics, particularly omalizumab, and ESS are cost-effective treatments for CRSwNP. However, mepolizumab combined with standard care was not cost-effective in Canada. Further comprehensive analyses are required to confirm these results.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE117
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)