OBJECTIVES: In 2019 Asthma Clinical Practice Guidelines (GINA) recommended the use of anti-IL4R for the treatment of patients at stage 5 of asthma. Given that dupilumab is an anti-IL4R recently approved in Colombia, the objective of this analysis is to calculate the budget impact and the direct costs of dupilumab, for the treatment of patients over 18 years with severe asthma, with eosinophilic phenotype or with oral corticosteroid dependent asthma, from the Colombian Healthcare System perspective.

METHODS: The analysis was conducted from the Colombian Healthcare System perspective with a time horizon of 5 years. The budget impact compared the financial effort difference between a current market scenario (omalizumab, mepolizumab, benralizumab, non-biologic treatments), and an alternative scenario with a progressive allocation of patients to dupilumab. Market share was obtained from public databases. Analysis also considered the patient's weight-dependent dose when needed. Prevalence and incidence data to calculate eligible population was obtained from literature. Direct medical events, medication, exacerbations and patient´s follow-up costs were calculated using public databases. Univariated deterministic sensitivity analysis was performed.

RESULTS: 93,006 hypothetical eligible patients were calculated. 143 lb were assumed as average weight for patients. Dupilumab represented cumulative savings for the Colombian Healthcare System along the 5 years of simulation for US$ 4.7 million, in comparison with the current scenario. Savings were mainly explained for reduction in number and severity of exacerbations. Most of the financial efforts were related with medication costs. Savings could be higher if dupilumab won higher market share, or if the average assumed weight for patients was higher.

CONCLUSIONS : Potential savings were observed due the inclusion of dupilumab for the treatment of patients over 18 with severe asthma with eosinophilic phenotype or with oral corticosteroid dependent asthma in Colombia.