CLINICAL AND ECONOMIC IMPACT OF SWITCHING PATIENTS WITH SEVERE EOSINOPHILIC ASTHMA CONTROLLED ON BENRALIZUMAB TO DEPEMOKIMAB IN THE UNITED STATES
Author(s)
Andre Verhoek, MSc1, Sofie Arnetorp, MSc2, Anna Quinton, BSc, MSc3.
1AstraZeneca, Barcelona, Spain, 2Health Economist & Payer Evidence, AstraZeneca, Mölndal, Sweden, 3AstraZeneca, Cambridge, United Kingdom.
1AstraZeneca, Barcelona, Spain, 2Health Economist & Payer Evidence, AstraZeneca, Mölndal, Sweden, 3AstraZeneca, Cambridge, United Kingdom.
OBJECTIVES: To assess the clinical and economic consequences of switching patients with controlled severe eosinophilic asthma (SEA) from benralizumab to depemokimab over one year from a US healthcare perspective.
METHODS: A cohort model (per 1000 patients; 1-year horizon) estimated total costs (drug plus exacerbation-related healthcare resource use), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER) with willingness-to-pay at $100,000/QALY. Clinical outcomes, i.e., annual exacerbation rates (AER), were derived from the NIMBLE study (Chupp et al. Am J Respir Crit Care Med. 2026;212(5):921-935). The AER post-switch were 0.48/year for benralizumab and 0.67/year for depemokimab. Asthma control was defined by number of exacerbations, use of maintenance oral corticosteroids, and Asthma Control Questionnaire (ACQ) score. Annual drug costs were calculated as list price per dose multiplied by annual dosing, with 6.5 doses for patients on benralizumab and 2 doses for patients on depemokimab. Distribution of exacerbation type was sourced from the MIRACLE study (Lai et al. Respir Med. 2024:107611), assuming the same distribution for both therapies. US unit costs and utilities were from published literature.
RESULTS: Switching 1000 patients with controlled SEA from benralizumab to depemokimab resulted in an additional 190 exacerbations, with 12% fewer patients having zero exacerbations and 74% more patients having three or more exacerbations. Switching from benralizumab to depemokimab also resulted in a loss of 4.5 QALYs annually. Costs of exacerbation-related healthcare resource increased by almost $300,000. Based on the ICER, it was more costly to switch patients controlled on benralizumab to depemokimab.
CONCLUSIONS: From a US healthcare perspective, it is more likely that switching patients controlled on benralizumab to depemokimab may result in higher exacerbation burden, lower QALYs and increased costs compared with remaining on benralizumab, under the assumptions of this analysis.
METHODS: A cohort model (per 1000 patients; 1-year horizon) estimated total costs (drug plus exacerbation-related healthcare resource use), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER) with willingness-to-pay at $100,000/QALY. Clinical outcomes, i.e., annual exacerbation rates (AER), were derived from the NIMBLE study (Chupp et al. Am J Respir Crit Care Med. 2026;212(5):921-935). The AER post-switch were 0.48/year for benralizumab and 0.67/year for depemokimab. Asthma control was defined by number of exacerbations, use of maintenance oral corticosteroids, and Asthma Control Questionnaire (ACQ) score. Annual drug costs were calculated as list price per dose multiplied by annual dosing, with 6.5 doses for patients on benralizumab and 2 doses for patients on depemokimab. Distribution of exacerbation type was sourced from the MIRACLE study (Lai et al. Respir Med. 2024:107611), assuming the same distribution for both therapies. US unit costs and utilities were from published literature.
RESULTS: Switching 1000 patients with controlled SEA from benralizumab to depemokimab resulted in an additional 190 exacerbations, with 12% fewer patients having zero exacerbations and 74% more patients having three or more exacerbations. Switching from benralizumab to depemokimab also resulted in a loss of 4.5 QALYs annually. Costs of exacerbation-related healthcare resource increased by almost $300,000. Based on the ICER, it was more costly to switch patients controlled on benralizumab to depemokimab.
CONCLUSIONS: From a US healthcare perspective, it is more likely that switching patients controlled on benralizumab to depemokimab may result in higher exacerbation burden, lower QALYs and increased costs compared with remaining on benralizumab, under the assumptions of this analysis.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE113
Topic
Clinical Outcomes, Economic Evaluation, Health Policy & Regulatory
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)