Pneumology Unit, 4th Floor, Agencia Sanitaria Costa del Sol, Carretera Nacional 340, Km 187, 29603, Marbella, Málaga, Spain.
Chair of Health Economics and Rational Use of Medicines, Department of Pharmacology and Clinical Therapeutics, Faculty of Medicine, University of Málaga, Málaga, Spain.
Respir Res. 2021 May 27;22(1):163. doi: 10.1186/s12931-021-01758-0.
Availability of clinically effective and cost-effective treatments for severe asthma would be beneficial to patients and national healthcare systems. The aim of this study was to evaluate clinical outcomes and healthcare expenditure after incorporating benralizumab into the standard treatment of refractory eosinophilic asthma.
This was a cross-sectional multicentre study of consecutive patients with refractory eosinophilic asthma who received treatment with benralizumab during at least 12 months. Patient follow-up was performed in specialised severe asthma units. The main effectiveness parameters measured were: the avoidance of one asthma exacerbation, a 3-point increase in the asthma control test (ACT) score, and the difference in utility scores (health-related quality of life) between a 1-year baseline treatment and 1-year benralizumab treatment. The health economic evaluation included direct costs and incremental cost-effectiveness ratios (ICERs).
After 1 year of treatment with benralizumab, patients with refractory eosinophilic asthma showed an improvement in all the effectiveness parameters analysed: improvement of asthma control and lung function, and decrease in the number of exacerbations, oral corticosteroid (both as corticosteroid courses and maintenance therapy), and inhaled corticosteroid use. The total annual cost per patient for the baseline and benralizumab treatment periods were €11,544 and €14,043, respectively, reflecting an increase in costs due to the price of the biological agent but a decrease in costs for the remaining parameters. The ICER was €602 per avoided exacerbation and €983.86 for every 3-point increase in the ACT score.
All the pharmacoeconomic parameters analysed show that treatment with benralizumab is a cost-effective option as an add-on therapy in patients with refractory eosinophilic asthma.
为严重哮喘患者提供临床有效且具成本效益的治疗方法将使患者和国家医疗保健系统受益。本研究的目的是评估贝那鲁肽纳入难治性嗜酸性粒细胞性哮喘标准治疗后对临床结局和医疗支出的影响。
这是一项连续纳入接受贝那鲁肽治疗至少 12 个月的难治性嗜酸性粒细胞性哮喘患者的横断面多中心研究。在专门的严重哮喘单位对患者进行随访。主要有效性参数测量包括：避免一次哮喘加重、哮喘控制测试（ACT）评分增加 3 分，以及基线治疗 1 年和贝那鲁肽治疗 1 年之间健康相关生活质量效用评分的差异。健康经济学评估包括直接成本和增量成本效益比（ICER）。
接受贝那鲁肽治疗 1 年后，难治性嗜酸性粒细胞性哮喘患者在所有分析的有效性参数方面均有所改善：哮喘控制和肺功能改善，以及哮喘加重、口服皮质类固醇（作为皮质类固醇疗程和维持治疗）和吸入皮质类固醇使用的次数减少。基线治疗和贝那鲁肽治疗期间每位患者的年总费用分别为 11544 欧元和 14043 欧元，反映了生物制剂价格上涨导致成本增加，但其余参数成本降低。每避免一次哮喘加重的 ICER 为 602 欧元，ACT 评分每增加 3 分的 ICER 为 983.86 欧元。
分析的所有药物经济学参数均表明，贝那鲁肽治疗作为难治性嗜酸性粒细胞性哮喘的附加治疗是一种具有成本效益的选择。
