COST-EFFECTIVENESS OF BIOLOGIC THERAPIES FOR SEVERE ASTHMA: A SYSTEMATIC LITERATURE REVIEW
Author(s)
Minghui Jiang, Master’s Candidate1, Chengkun Lyu, Master’s Candidate2, Powei Wu, MSc3, Shaoyu Wu, PhD1, Jianwei Xuan, PhD3.
1School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China, 2School of Public Health, Peking University, Beijing, China, 3Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China.
1School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China, 2School of Public Health, Peking University, Beijing, China, 3Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China.
OBJECTIVES: This systematic literature review (SLR) aimed to identify and synthesize cost-effectiveness evidence for biologic therapies in adults with severe asthma and to summarize study characteristics.
METHODS: PubMed, Embase, and Web of Science were searched from inception to December 2025, supplemented by major HTA agency websites. English-language full-text studies reporting full economic evaluations of biologic therapies in adults with severe asthma were included. Data were extracted on setting, phenotype, interventions/comparators, model design, time horizon, cycle length, discounting, and perspective.
RESULTS: From 966 identified records, 23 studies were included; most used Markov models (20/23). The biologic therapies assessed in the included studies comprised omalizumab, mepolizumab, benralizumab, reslizumab, tezepelumab, and dupilumab. The included studies were conducted in North America, Europe, Latin America, Asia-Pacific, and Middle East. Time horizons ranged from 1 year to lifetime; cycle lengths ranged from 1-12 weeks (most commonly 4 weeks). Most studies (20/23) applied discounting to both costs and outcomes, using rates ranging from 1.5% to 5%. Benralizumab was cost-effective in all included evaluations (4/4 studies; 8/9 comparisons) and was dominant in at least one analysis. Evidence for dupilumab and tezepelumab suggested favorable cost-effectiveness but was supported by only one study for each agent. Reslizumab showed mixed cost-effectiveness (1/2 studies). Results for mepolizumab were heterogeneous (cost-effective in 2/4 studies), whereas omalizumab was least frequently deemed cost-effective (4/11 studies).
CONCLUSIONS: Benralizumab showed the most consistent cost-effectiveness across the included evidence. Dupilumab and tezepelumab appeared favorable but were supported by limited studies; findings for mepolizumab were mixed. As clinical evidence for recently introduced biologics in asthma continues to grow, synthesizing cost-effectiveness evidence for these treatments can inform future clinical and economic research and support more equitable allocation of scarce healthcare resources.
METHODS: PubMed, Embase, and Web of Science were searched from inception to December 2025, supplemented by major HTA agency websites. English-language full-text studies reporting full economic evaluations of biologic therapies in adults with severe asthma were included. Data were extracted on setting, phenotype, interventions/comparators, model design, time horizon, cycle length, discounting, and perspective.
RESULTS: From 966 identified records, 23 studies were included; most used Markov models (20/23). The biologic therapies assessed in the included studies comprised omalizumab, mepolizumab, benralizumab, reslizumab, tezepelumab, and dupilumab. The included studies were conducted in North America, Europe, Latin America, Asia-Pacific, and Middle East. Time horizons ranged from 1 year to lifetime; cycle lengths ranged from 1-12 weeks (most commonly 4 weeks). Most studies (20/23) applied discounting to both costs and outcomes, using rates ranging from 1.5% to 5%. Benralizumab was cost-effective in all included evaluations (4/4 studies; 8/9 comparisons) and was dominant in at least one analysis. Evidence for dupilumab and tezepelumab suggested favorable cost-effectiveness but was supported by only one study for each agent. Reslizumab showed mixed cost-effectiveness (1/2 studies). Results for mepolizumab were heterogeneous (cost-effective in 2/4 studies), whereas omalizumab was least frequently deemed cost-effective (4/11 studies).
CONCLUSIONS: Benralizumab showed the most consistent cost-effectiveness across the included evidence. Dupilumab and tezepelumab appeared favorable but were supported by limited studies; findings for mepolizumab were mixed. As clinical evidence for recently introduced biologics in asthma continues to grow, synthesizing cost-effectiveness evidence for these treatments can inform future clinical and economic research and support more equitable allocation of scarce healthcare resources.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE497
Topic
Economic Evaluation
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), STA: Biologics & Biosimilars