Oba Yuji, Salzman Gary A
Division of Respiratory and Critical Care Medicine, University of Missouri-Kansas City School of Medicine, MO 64108-2792, USA.
J Allergy Clin Immunol. 2004 Aug;114(2):265-9. doi: 10.1016/j.jaci.2004.05.049.
Omalizumab can reduce hospitalization and emergency department visits and improve quality of life in patients with moderate-to-severe, suboptimally controlled allergic asthma. Given the high cost and modest efficacy of this agent, it is not clear that it is cost-effective if given to a broad population with asthma.
The purpose of this study was to evaluate the cost-effectiveness of omalizumab in adults and adolescents with moderate-to-severe allergic asthma.
A retrospective economic analysis was performed to determine the cost-effectiveness of omalizumab using 52-week data from 2 randomized controlled clinical trials in adults and adolescents with moderate-to-severe allergic asthma. The analysis was conducted from a third-party payer's perspective, and only direct costs were considered.
The incremental cost-effectiveness ratios showed that the cost to achieve an additional successfully controlled day was $523, and the daily cost to achieve at least a 0.5-point increase in Asthma Quality of Life Questionnaire score was $378 in 2003 dollars.
From a pharmacoeconomic standpoint, omalizumab would be better used in allergic asthmatic patients with poorly controlled symptoms despite maximal therapy, given the high cost and modest efficacy of this agent. It could be cost saving if given to nonsmoking patients who are hospitalized 5 or more times or 20 days or longer per year despite maximal asthma therapy.
奥马珠单抗可减少中重度、控制不佳的过敏性哮喘患者的住院次数和急诊就诊次数，并改善其生活质量。鉴于该药物成本高昂且疗效一般，对于广泛的哮喘患者群体使用该药是否具有成本效益尚不清楚。
本研究旨在评估奥马珠单抗在成人和青少年中重度过敏性哮喘患者中的成本效益。
进行一项回顾性经济分析，利用两项针对成人和青少年中重度过敏性哮喘的随机对照临床试验的52周数据来确定奥马珠单抗的成本效益。该分析从第三方支付方的角度进行，仅考虑直接成本。
增量成本效益比显示，在2003年美元价值下，实现额外一个成功控制日的成本为523美元，使哮喘生活质量问卷得分至少提高0.5分的每日成本为378美元。
从药物经济学角度来看，鉴于奥马珠单抗成本高昂且疗效一般，对于症状尽管接受最大程度治疗仍控制不佳的过敏性哮喘患者，使用该药可能更为合适。对于尽管接受最大程度哮喘治疗但每年仍住院5次或更多次或住院20天或更长时间的非吸烟患者，使用该药可能会节省成本。
