OBJECTIVES

Adding biological asthma treatments to standard therapy with inhaled corticosteroids and controller medications decreases asthma exacerbations and use of long-term steroids in patients with severe disease and increased eosinophils; however, they are costly and its cost-effectiveness in Colombia is unknown. Our objective is to estimate the cost-utility of benralizumab.

METHODS

A discrete events model was used in a cohort of 1000 adults with severe eosinophilic asthma with 26.3 years old, a life expectancy of 80 years, from a societal perspective, comparing benralizumab, omalizumab, mepolizumab plus standard of care (SoC) and for SoC alone, in terms of clinical and economic outcomes over a two years horizon. Both costs and health outcomes had an annual rate discount of 5%. A responder scenario analysis was conducted to determine cost-effectiveness incremental ratio (ICER) per quality-adjusted life year (QALYs) and life-years gained (LYGs) for benralizumab versus its comparators. Both healthcare and loss of productivity costs were included.

RESULTS

Over a two years treatment horizon, benralizumab averted 3,046 rescue events vs SoC alone, 1,091 vs omalizumab and 477 vs mepolizumab. In the same way, benralizumab avoided 2,775 emergency room visits vs SoC, 130 vs omalizumab and 123 vs mepolizumab. Benralizumab averted 3,016 hospitalizations because asthma exacerbations vs SoC, 584 vs omalizumab and 1,164 vs mepolizumab. Similarly, benralizumab averted 33,570 days of disability vs SoC, 5,781 vs omalizumab and 9,408 vs mepolizumab. Treatment with benralizumab plus Soc vs SoC alone resulted in an ICER of $304 per QALY and $2,153 per LYG. Benralizumab was cost-saving vs omalizumab and mepolizumab in terms of QALYs and LYGs.

CONCLUSIONS

Benralizumab is a dominant strategy versus omalizumab and mepolizumab. ICER value threshold vs SoC alone is under 1 gross domestic product in Colombia, it means that benralizumab is a cost-effectiveness treatment in patients with severe eosinophilic asthma, because averted more exacerbations and productivity loss.