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Abstract
BackgroundAvailability 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.MethodsThis 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).ResultsAfter 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.ConclusionsAll 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.
Highlights
Availability of clinically effective and cost-effective treatments for severe asthma would be beneficial to patients and national healthcare systems
Asthma is a heterogeneous condition characterised by chronic inflammation of the pulmonary airways [1] with an estimated 300 million people currently affected worldwide [2], and its prevalence has been increasing in recent years
We found that 100% of patients responded to benralizumab treatment, and 79.6% had a very good response, while only nine patients showed a partial response with eight remaining corticosteroid-dependent and one, who was corticosteroid-dependent and despite managing to discontinue permanently oral corticosteroids (OCS), required two courses of OCS during that year, a > 50% reduction in OCS use was observed
Summary
The aim of this study was to evaluate clinical outcomes and healthcare expenditure after incorporating benralizumab into the standard treatment of refractory eosinophilic asthma. Availability of clinically effective and cost-effective treatments for severe asthma would be beneficial to patients and national healthcare systems. There are currently four biologic agents available in Spain for the treatment of severe asthma: omalizumab, mepolizumab, reslizumab, and benralizumab. Several studies performed in different healthcare settings have provided evidence on the advantages of omalizumab [11,12,13], mepolizumab [14, 15], and reslizumab [16] as add-on therapies in terms of cost-effectiveness in the management of severe asthma patients
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