OBJECTIVES: Benralizumab is a humanized monoclonal antibody. It is indicated for adult patients with severe uncontrolled eosinophilic asthma despite baseline standard therapy. This study aims to assess the cost-effectiveness of introducing Benralizumab as an add-on therapy for the indicated patients in PSMMC.

METHODS: A three-state excel based Markov model was adapted using 3 Phase III trials (ZONDA, SIROCCO and CALIMA) to assess the incremental cost-effectiveness ratio of Benralizumab vs. standard of care (SOC) alone and vs. Omalizumab. Health outcomes were estimated in terms of quality adjusted life years (QALYs) over a lifetime-horizon. Patients with severe uncontrolled asthma were defined as those on chronic oral corticosteroids (OCS) use or ≥3 exacerbations; baseline eosinophil count of ≥300 cells/µL in the previous year. Key model inputs included rates of exacerbations, treatment response rates, OCS-sparing, and cost-components.

RESULTS: Benralizumab demonstrated a cost-effectiveness ratio of SAR 372,674 ($ 99,380) / QALY gain vs SOC, while it has shown to be a dominant option when compared to SOC in addition to Omalizumab, generating incremental 0.1 QALYs per patient at an incremental cost of SAR -268,551 ($ -71,614). Benralizumab was associated with a lower number of asthma exacerbations equals to 4.73 exacerbations Vs. SOC alone, generating an ICER of SAR 52,871 ($ 14,098) per exacerbation avoided. The increment in cost is mainly derived by total treatment costs which includes medications, administration, adverse events management and add-on costs like physician visits and Laboratory tests. The one-way sensitivity analysis showed that day-to-day utility was the most influential parameter when comparing Benralizumab to SOC alone and SOC plus Omalizumab. The cost-effectiveness acceptability curve illustrated a probability near 0% of Omalizumab being cost-effective when compared to Benralizumab.

CONCLUSIONS: Benralizumab is a dominant option when compared to Omalizumab, generating higher QALYs per patient at lower costs over a life-time horizon.