Abstract | BACKGROUND:
Omalizumab (trade name Xolair) is approved by the US Food and Drug Administration for treatment of moderate-to-severe allergic asthma. Given the high acquisition cost of omalizumab, its role and cost-effectiveness in disease management require definition. OBJECTIVE: We sought to identify the clinical and economic circumstances under which omalizumab might or might not be a cost-effective option by using a mathematic model. METHODS: We merged published data on clinical and economic outcomes (including acute event incidence, frequency/severity of hospitalizations, and health-related quality of life) to project 10-year costs, quality-adjusted life years (QALYs), and cost-effectiveness of treatment with omalizumab in addition to inhaled corticosteroids. Sensitivity analyses were conducted by using input data ranges from a variety of sources (published clinical trials and observational databases). RESULTS: For patients with baseline acute event rates, omalizumab conferred an additional 1.7 quality-adjusted months at an incremental cost of $131,000 over a 10-year planning horizon, implying a cost-effectiveness ratio of $821,000 per QALY gained. For patients with 5 times the baseline acute event rate, the cost-effectiveness ratio was $491,000 per QALY gained. The projected cost-effectiveness ratio could fall within a range of other programs that are widely considered to be cost-effective if the cost of omalizumab decreases to less than $200. CONCLUSION:
Omalizumab is not cost-effective for most patients with severe asthma. The projected cost-effectiveness ratios could fall within a favorable range if the cost of omalizumab decreases significantly. CLINICAL IMPLICATIONS: Based on the high cost of omalizumab, it is especially important that clinicians explore alternative medications for asthma before initiating omalizumab.
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Authors | Ann C Wu, A David Paltiel, Karen M Kuntz, Scott T Weiss, Anne L Fuhlbrigge |
Journal | The Journal of allergy and clinical immunology
(J Allergy Clin Immunol)
Vol. 120
Issue 5
Pg. 1146-52
(Nov 2007)
ISSN: 1097-6825 [Electronic] United States |
PMID | 17904628
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Anti-Allergic Agents
- Antibodies, Anti-Idiotypic
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Humanized
- Omalizumab
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Topics |
- Anti-Allergic Agents
(economics, therapeutic use)
- Antibodies, Anti-Idiotypic
- Antibodies, Monoclonal
(economics, therapeutic use)
- Antibodies, Monoclonal, Humanized
- Asthma
(drug therapy, economics)
- Cost-Benefit Analysis
- Humans
- Models, Theoretical
- Omalizumab
- Severity of Illness Index
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