Objectives: Severe asthma is a high-cost chronic disease with different inflammatory phenotypes, eosinophilic phenotype is the most common. Benralizumab is a monoclonal antibody that targets this phenotype. This study evaluated cost-utility ratio of Benralizumab in patients with severe eosinophilic asthma in Colombia.

Method: A Markov-model was developed considering five-disease-stages: no exacerbation, exacerbations requiring oral corticosteroids (OCS), exacerbations requiring emergency department (ED) visit, exacerbations requiring hospitalization and death. A cohort of 100 patients was modelled from the social-perspective comparing Standard of Care (SoC), Benralizumab, Omalizumab and Mepolizumab, in terms of avoided exacerbations requiring OCS, ED visits and/or hospitalizations, with three time-horizons at 1, 3 and 5 years; outcomes are reported in Quality-Adjusted Life Years (QALYs). Costs and healthcare values were discounted by 5% annually, efficacy was based on the pivotal studies. Base-case were 50-year-old-patients with uncontrolled severe asthma. Direct and indirect healthcare costs were considered. Willingness-to-Pay (WTP) threshold used was 1 gross domestic product per capita in Colombia (USD 5,333).

Results: Total costs first year to SoC are $1,703,097; Benralizumab, $2,837,121; Mepolizumab, $2,837,121; Omalizumab, $3,006,832. Total QALYs first year to SoC are 36; Benralizumab, 88; Mepolizumab, 82.9; Omalizumab, 83.3. Total costs third year to SoC are $4,022,140; Benralizumab, $4,997,285; Mepolizumab, $5,329,573; Omalizumab, $5,947,482. Total QALYs third year to SoC are 100; Benralizumab, 260; Mepolizumab, 243; Omalizumab, 245. Total costs fifth year to SoC are $5,824,208; Benralizumab, $6,902,952; Mepolizumab, $7,638,669; Omalizumab, $8,518,251. Total QALYs fifth year to SoC are 155; Benralizumab, 427; Mepolizumab, 396; Omalizumab, 402. Benralizumab is a cost-saving strategy versus Mepolizumab and Omalizumab. ICER of Benralizumab vs SoC is $6,115 third year, and $3,971 fifth year.

Conclusions: Benralizumab versus SoC is a potentially cost-effective strategy for severe asthma in Colombia at third year, and a cost-effective treatment at fifth year, and it is a dominant strategy versus Mepolizumab and Omalizumab.