OBJECTIVES : To conduct a comparative pharmacoeconomics of omalizumab, mepolizumab and reslizumab in the treatment of patients with uncontrolled moderate and severe atopic asthma in the Russian health care setting.

METHODS : Pharmacoeconomic model based on published randomized clinical studies results and meta-analysis data for omalizumab, mepolizumab and reslizumab was built. Patient cross-population based on local epidemiological data and indications of each Bx was defined. Comparative cost-effectiveness analysis (CEA) and budget impact analysis (BIA) was done. Number of prevented exacerbations used as effectiveness in CEA. BIA demonstrated partial replacement of omalizumab with mepolizumab and / or reslizumab in . The study horizon is 3 years. The direct medical costs consists: costs on basic pharmacotherapy, Bx, monitoring and administration of the treatment, hospitalization. Exchange rate was 1 EUR = 72, 42 RUB.

RESULTS : Omalizumab usage requires 13.3% less direct medical costs than reslizumab and 1.6% more than mepolizumab for an equal period of time. It makes up 150.56 euros less than reslizumab and 15.35 euros more than mepolizumab for 4 weeks treatment accordingly. The cost to prevent exacerbations of omalizumab is 24.80% lower than reslizumab and 20.89% lower than mepolizumab. A sensitivity analysis of CEA results demonstrates resistance to price fluctuations of the compared drugs by 10%. BIA shows that gradual switching over 15% of defined profile patients from omalizumab to mepolizumab and reslizumab will lead to budget increase.

CONCLUSIONS : Pharmacoeconomic results demonstrate the efficiency of omalizumab in compare with reslizumab and mepolizumab in the treatment of patients with uncontrolled moderate and severe atopic asthma in the Russian health care setting