Economic Value of Dupilumab in Preventing and Treating Comorbid Asthma in Pediatric Patients With Atopic Dermatitis: A Cost-Offset Model From the Italian Payer Perspective
Author(s)
Oriol de Sola-Morales, MD, PhD1, Jules TAVI, PharmD, MSc2, Gaelle Bego Le Bagousse, Sr., MSc2, Donia Bahloul, PharmD, MSc2, Andreas Kuznik, PhD3, Zhixiao Wang, PhD3, Kerry Jane Noonan, BA4.
1Fundació HiTT, Barcelona, Spain, 2Sanofi, Gentilly, France, 3Regeneron Pharmaceuticals, Inc., Sleepy Hollow, NY, USA, 4Sanofi, Cambridge, MA, USA.
1Fundació HiTT, Barcelona, Spain, 2Sanofi, Gentilly, France, 3Regeneron Pharmaceuticals, Inc., Sleepy Hollow, NY, USA, 4Sanofi, Cambridge, MA, USA.
OBJECTIVES: Type 2 (T2) inflammation is an underlying mechanism for multiple atopic diseases, often manifesting as "Atopic March"—a progression starting with atopic dermatitis (AD) in childhood and advancing to other atopic diseases such as asthma later. Dupilumab inhibits interleukin (IL)-4/IL-13—key drivers of T2 inflammation—thereby demonstrating efficacy in various T2-mediated conditions. We evaluated expected cost-offsets with dupilumab vs. conventional therapies in treating paediatric patients with AD and preventing comorbid asthma development.
METHODS: A cost-offset model with a 5-year time horizon was adopted from an Italian payer perspective. Patients aged 6-12 years who initiated dupilumab or conventional therapies (systemic corticosteroids/conventional immunomodulators) for severe AD were modelled. Eligible population (N=5,834) was estimated from overall Italian population (58.9M). From literature, the model assumed that 4.0% (n=233) of AD patients had comorbid severe asthma, and 5.0% (n=280) from remaining 96.0% were expected to develop asthma in future. We estimated total annual costs (2024€, including direct healthcare costs: inpatient/hospitalisation, outpatient, emergency room, and pharmacy) for AD, prevalent asthma and avoided incident asthma, and asthma cases and healthcare resource utilisation (HCRU), based on published real-world progression data. Dupilumab cost was not included. Economic data and cumulative risk reduction of asthma incidence in AD patients were derived from published studies.
RESULTS: Total cumulative 5-year HCRU costs were consistently lower for dupilumab vs. conventional therapies: overall: €61.6M vs. €107.8M, 43% reduction; AD: €36.2M vs. €61.4M, 41% reduction; prevalent asthma: €6.7M vs. €11.5, 42% reduction; and avoided incident asthma: €18.7M vs. €34.8M, 46% reduction. Additionally, asthma cases (5-year: 662 vs. 1,199; 45% reduction) and cumulative HCRU claims (325,208 vs. 610,460; 47% reduction) were lower with dupilumab vs. conventional therapies.
CONCLUSIONS: Our model estimated that dupilumab, a therapy targeted at T2 disease, potentially reduces costs and HCRU related to prevalent and future incident asthma vs. conventional therapies in paediatric AD patients.
METHODS: A cost-offset model with a 5-year time horizon was adopted from an Italian payer perspective. Patients aged 6-12 years who initiated dupilumab or conventional therapies (systemic corticosteroids/conventional immunomodulators) for severe AD were modelled. Eligible population (N=5,834) was estimated from overall Italian population (58.9M). From literature, the model assumed that 4.0% (n=233) of AD patients had comorbid severe asthma, and 5.0% (n=280) from remaining 96.0% were expected to develop asthma in future. We estimated total annual costs (2024€, including direct healthcare costs: inpatient/hospitalisation, outpatient, emergency room, and pharmacy) for AD, prevalent asthma and avoided incident asthma, and asthma cases and healthcare resource utilisation (HCRU), based on published real-world progression data. Dupilumab cost was not included. Economic data and cumulative risk reduction of asthma incidence in AD patients were derived from published studies.
RESULTS: Total cumulative 5-year HCRU costs were consistently lower for dupilumab vs. conventional therapies: overall: €61.6M vs. €107.8M, 43% reduction; AD: €36.2M vs. €61.4M, 41% reduction; prevalent asthma: €6.7M vs. €11.5, 42% reduction; and avoided incident asthma: €18.7M vs. €34.8M, 46% reduction. Additionally, asthma cases (5-year: 662 vs. 1,199; 45% reduction) and cumulative HCRU claims (325,208 vs. 610,460; 47% reduction) were lower with dupilumab vs. conventional therapies.
CONCLUSIONS: Our model estimated that dupilumab, a therapy targeted at T2 disease, potentially reduces costs and HCRU related to prevalent and future incident asthma vs. conventional therapies in paediatric AD patients.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE404
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Biologics & Biosimilars, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Sensory System Disorders (Ear, Eye, Dental, Skin)