Entrenas Costa Luis Manuel, Casas-Maldonado Francisco, Soto Campos José Gregorio, Padilla-Galo Alicia, Levy Alberto, Álvarez Gutiérrez Francisco Javier, Gómez-Bastero Fernández Ana P, Morales-García Concepción, Gallego Domínguez Rocío, Villegas Sánchez Gustavo, Mateos Caballero Luis, Pereira-Vega Antonio, García Polo Cayo, Pérez Chica Gerardo, Martín Villasclaras Juan José
Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, Avda. de las Ollerías 1, portal 10 4-2, 14001, Córdoba, Spain.
Unidad de Gestión Clínica de Neumología, Hospital Universitario San Cecilio, Granada, Spain.
Pharmacoecon Open. 2019 Sep;3(3):333-342. doi: 10.1007/s41669-019-0117-4.
Omalizumab is a fully humanized monoclonal antibody indicated as add-on therapy to improve asthma control in patients with severe persistent allergic asthma.
The aim of this study was to evaluate social, healthcare expenditure and clinical outcomes changes after incorporating omalizumab into standard treatment in the control of severe asthma.
In this multicentre retrospective study, a total of 220 patients were included from 15 respiratory medicine departments in the regions of Andalusia and Extremadura (Spain). Effectiveness was calculated as a 3-point increase in the Asthma Control Test (ACT) and a reduction in the annual number of exacerbations. The economic evaluation included both direct and indirect costs. Incremental cost-effectiveness ratio (ICER) was calculated. Results from the year before and the year after incorporation of omalizumab were compared.
After adding omalizumab, improvement of lung function, asthma and rhinitis according to patient perception, as well as the number of exacerbations and asthma control measured by the ACT score were observed. Globally, both healthcare resources and pharmacological costs decreased after omalizumab treatment, excluding omalizumab cost. When only direct costs were considered, the ICER was €1712 (95% CI 1487-1995) per avoided exacerbation and €3859 (95% CI 3327-4418) for every 3-point increase in the ACT score. When both direct and indirect costs were considered, the ICER was €1607 (95% CI 1385-1885) for every avoided exacerbation and €3555 (95% CI 3012-4125) for every 3-point increase.
Omalizumab was shown to be an effective add-on therapy for patients with persistent severe asthma and allowed reducing key drivers of asthma-related costs.
奥马珠单抗是一种全人源单克隆抗体，被用作附加疗法，以改善重度持续性过敏性哮喘患者的哮喘控制情况。
本研究的目的是评估在重度哮喘控制中，将奥马珠单抗纳入标准治疗后，社会、医疗保健支出及临床结局的变化。
在这项多中心回顾性研究中，共纳入了来自西班牙安达卢西亚和埃斯特雷马杜拉地区15个呼吸内科的220名患者。有效性通过哮喘控制测试（ACT）得分提高3分以及年度急性加重次数减少来计算。经济评估包括直接成本和间接成本。计算增量成本效益比（ICER）。比较了纳入奥马珠单抗前一年和后一年的结果。
添加奥马珠单抗后，观察到根据患者感知的肺功能、哮喘和鼻炎改善情况，以及急性加重次数和通过ACT评分衡量的哮喘控制情况。总体而言，除奥马珠单抗成本外，奥马珠单抗治疗后医疗保健资源和药物成本均下降。仅考虑直接成本时，每避免一次急性加重的ICER为1712欧元（95%CI 1487 - 1995），ACT评分每提高3分的ICER为3859欧元（95%CI 3327 - 4418）。同时考虑直接成本和间接成本时，每避免一次急性加重的ICER为1607欧元（95%CI 1385 - 1885），每提高3分的ICER为3555欧元（95%CI 3012 - 4125）。
奥马珠单抗被证明是持续性重度哮喘患者的一种有效附加疗法，且能够降低哮喘相关成本的关键驱动因素。
