OBJECTIVES : Omalizumab is a monoclonal antibody approved in China as an add-on therapy to improve control in patients with severe persistent allergic asthma. This study aimed to examine the cost-effectiveness of Omalizumab plus standard-of-care (SoC) compared to SoC in Chinese setting.

METHODS : A previously published Markov model was adapted to evaluate the cost-effectiveness of Omalizumab from the societal perspective. The model period is 3 months, simulating the progress of the disease throughout life. Exacerbation rates were obtained from the post-marketing observational registry (eXpeRience). Mortality data were based on the most recent Chinese actuarial life tables. The direct cost data was derived from the China national claim data base or other governmental sources in public domains, while indirect costs as productivity loss, were from published literatures. Utility values for the health states extracted from the eXpeRience and a UK study. Both costs and quality-adjusted life years (QALYs) were discounted annually at 3%. One-way sensitivity and probability sensitivity analyses (PSA) were conducted to examine the robustness of the base-case findings.

RESULTS : In the base-case analysis, the lifetime total costs were higher for Omalizumab plus SoC at $187,271 compared with $99,292 for SoC. The QALYs gained were 9.56 and 5.52 for patients treated with Omalizumab plus SoC and SoC only, respectively. The ICER of Omalizumab plus SoC vs SOC was $21,766/QALY, which is under the threshold of 3 times per capita GDP of China in 2017 ($26,465). One-way sensitivity analysis showed that ICER was sensitive to retirement age and Omalizumab’s price. Findings from the PSA indicated that the likelihood of Omalizumab plus SoC being cost-effective was 72.00%.

CONCLUSIONS : Compared with SoC, severe allergic uncontrolled asthma treatment with Omalizumab plus SoC is more expensive but also with greater QALYs gains. On balance, add-on Omalizumab for uncontrolled severe allergic asthma is cost-effective from the Chinese societal perspective.