OBJECTIVES

Severe asthma is associated with a substantial disease burden. Patients who require treatment with oral corticosteroids (OCS) experience an even greater burden in terms of adverse events related to the OCS treatment. To optimally address both the clinical- and the economic burden associated with severe asthma, treatment must be clinically efficacious and cost-effective, and the relevant patient population must be clearly defined. The objective was to investigate cost effectiveness of benralizumab versus standard of care (SOC) plus OCS for patients with severe, eosinophilic OCS-dependent asthma in Sweden. Patients with severe asthma were defined as those receiving OCS ≥5 mg/day.

METHODS

A three-state, cohort-based Markov model populated with data from three phase III benralizumab clinical trials, mainly the OCS-sparing trial ZONDA (ClinicalTrials.gov number, NCT02075255), was used to assess the incremental cost-effectiveness ratio of benralizumab vs. SOC plus OCS. Health outcomes were estimated in terms of quality-adjusted life-years (QALYs). The model reflected societal perspective and captured long term impact of treatments, including OCS-related morbidity. All cost inputs were based on 2018 price level.

RESULTS

Benralizumab demonstrated a cost-effectiveness ratio versus SOC plus OCS of Swedish Kronor (SEK) 366,855 (€34,127) per QALY gained, based on increases of 1.33 QALYs and SEK 488,742 (€45,344) per patient over a lifetime horizon. Benralizumab acquisition costs were the main contributor to the incremental costs. Results of a one-way sensitivity analyses indicated that day-to-day utilities, especially for patients on SOC with and without regular OCS use were the parameters with the greatest impact on the incremental cost-effectiveness ratio. A probabilistic sensitivity analysis demonstrated low uncertainty of the cost-effectiveness results.

CONCLUSIONS

The results indicate that benralizumab has a high probability of being cost-effective compared with SOC plus OCS for patients with severe, eosinophilic asthma receiving regular OCS treatment.