CLINICAL AND ECONOMIC OUTCOMES AMONG PATIENTS WITH SEVERE EOSINOPHILIC ASTHMA WHO SWITCHED FROM MEPOLIZUMAB TO BENRALIZUMAB FROM A UNITED STATES HEALTHCARE SYSTEM PERSPECTIVE
Author(s)
Andre Verhoek, MSc1, Sofie Arnetorp, MSc2, Anna Quinton, BSc, MSc3, Benjamin Emmanuel, PhD4.
1AstraZeneca, Barcelona, Spain, 2Health Economist & Payer Evidence, AstraZeneca, Mölndal, Sweden, 3AstraZeneca, Cambridge, United Kingdom, 4AstraZeneca, Gaithersburg, MD, USA.
1AstraZeneca, Barcelona, Spain, 2Health Economist & Payer Evidence, AstraZeneca, Mölndal, Sweden, 3AstraZeneca, Cambridge, United Kingdom, 4AstraZeneca, Gaithersburg, MD, USA.
OBJECTIVES: To evaluate the clinical and economic outcomes among patients with severe eosinophilic asthma (SEA) who switched from mepolizumab to benralizumab over one year from a US healthcare system perspective.
METHODS: A cohort model (per 1000 patients; 1-year horizon) estimated total costs (drug and exacerbation-related healthcare resource use), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), and net monetary benefit (NMB; willingness-to-pay $100,000/QALY). Annual asthma exacerbation rate (AAER) and distribution of exacerbation-type was based on the ZEPHYR-1 US study (Chung et al. Ann Allergy Asthma Immunol. 2022;128(6):669-676). Among patients with SEA treated with mepolizumab (n=97), the AAER was 1.56 (including median time period of 78 days without mepolizumab before starting benralizumab) and 1.02 after switching to benralizumab. The distribution of exacerbation types for mepolizumab and benralizumab was; exacerbations requiring oral corticosteroids only: 53% and 58%, emergency department visits: 34% and 30%, hospitalization: 13% and 12%, respectively. Annual drug costs were calculated as list price per dose multiplied by annual dosing (mepolizumab 13 doses; benralizumab 8 doses, reflecting loading-phase). US unit costs and utilities were from published literature.
RESULTS: Switching 1000 patients previously treated with mepolizumab to benralizumab was estimated to avoid 540 exacerbations, gain 12 QALYs, and cost saving of nearly $1.8 million annually through reduces use of exacerbation-related healthcare resources. Based on this study, it is cost-effective to switch to benralizumab (provides better health outcomes at lower cost), with a positive net monetary benefit at a threshold of $100,000 per QALY.
CONCLUSIONS: In a 1-year cohort model, patients with SEA who switched from mepolizumab to benralizumab had fewer exacerbations, gained more QALYs, and incurred lower total costs. Switching to benralizumab was cost-effective, providing better health outcomes at lower cost, with a positive net monetary benefit at a $100,000/QALY threshold.
METHODS: A cohort model (per 1000 patients; 1-year horizon) estimated total costs (drug and exacerbation-related healthcare resource use), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), and net monetary benefit (NMB; willingness-to-pay $100,000/QALY). Annual asthma exacerbation rate (AAER) and distribution of exacerbation-type was based on the ZEPHYR-1 US study (Chung et al. Ann Allergy Asthma Immunol. 2022;128(6):669-676). Among patients with SEA treated with mepolizumab (n=97), the AAER was 1.56 (including median time period of 78 days without mepolizumab before starting benralizumab) and 1.02 after switching to benralizumab. The distribution of exacerbation types for mepolizumab and benralizumab was; exacerbations requiring oral corticosteroids only: 53% and 58%, emergency department visits: 34% and 30%, hospitalization: 13% and 12%, respectively. Annual drug costs were calculated as list price per dose multiplied by annual dosing (mepolizumab 13 doses; benralizumab 8 doses, reflecting loading-phase). US unit costs and utilities were from published literature.
RESULTS: Switching 1000 patients previously treated with mepolizumab to benralizumab was estimated to avoid 540 exacerbations, gain 12 QALYs, and cost saving of nearly $1.8 million annually through reduces use of exacerbation-related healthcare resources. Based on this study, it is cost-effective to switch to benralizumab (provides better health outcomes at lower cost), with a positive net monetary benefit at a threshold of $100,000 per QALY.
CONCLUSIONS: In a 1-year cohort model, patients with SEA who switched from mepolizumab to benralizumab had fewer exacerbations, gained more QALYs, and incurred lower total costs. Switching to benralizumab was cost-effective, providing better health outcomes at lower cost, with a positive net monetary benefit at a $100,000/QALY threshold.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE256
Topic
Economic Evaluation, Health Policy & Regulatory
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)