Cost effectiveness of benralizumab for severe, uncontrolled oral corticosteroid–dependent asthma in Sweden. (2nd August 2020)

• Record Type: Journal Article
• Authors: Andersson, Maria; Janson, Christer; Kristensen, Thomas; Szende, Agota; Golam, Sarowar
• Is Part Of: Journal of medical economics. Volume 23:Number 8(2020)
• Page Start: 877
• Page End: 884
• Publication Date: 2020-08-02
• Subjects: Benralizumab -- cost-effectiveness analysis -- oral corticosteroids -- severe asthma; I10 -- I11 -- I15 -- I18; Medical care -- Cost control -- Periodicals; Medical economics -- Periodicals; 362.10941
• DOI: 10.1080/13696998.2020.1760285
• Languages: English
• ISSNs: 1369-6998

Abstract

Abstract: Aim: We investigated cost effectiveness of benralizumab vs. standard of care (SOC) plus oral corticosteroids (OCS) for patients with severe, eosinophilic OCS-dependent asthma in Sweden. Materials and methods: A three-state, cohort-based Markov model of data from three Phase III benralizumab clinical trials (ZONDA [NCT02075255], SIROCCO [NCT01928771], and CALIMA [NCT01914757]) was used to assess the incremental cost-effectiveness ratio of benralizumab vs. SOC plus OCS. Health outcomes were estimated in terms of quality-adjusted life-years (QALYs). The model included costs and disutilities associated with extrapolated OCS-related adverse events. Patients with severe asthma were defined as those receiving OCS ≥5 mg/day. Results: Benralizumab demonstrated a cost-effectiveness ratio vs. SOC plus OCS of 2018 Swedish Kronor (SEK) 366, 855 (€34, 127) per QALY gained, based on increases of 1.33 QALYs and SEK 488, 742 (€45, 344) per patient. Benralizumab treatment costs contributed most to incremental costs. The probability of benralizumab's being cost-effective with willingness-to-pay (WTP) thresholds between SEK 429, 972 (€40, 000) and SEK 752, 452 (€70, 000) ranged from 75% to 99%. Limitations: Potential limitations of these analyses include the use of combined data from three different clinical trials, a one-way sensitivity analysis that did not include mortality and transition estimates, and Observational & Pragmatic Research Institute (OPRI) data from the UK as a proxy of the Swedish health care system. Conclusions: The results of these analyses demonstrate that benralizumab has a high probability of being cost-effective compared with SOC plus OCS for a subgroup of patients with severe, eosinophilic asthma receiving regular OCS treatment and may support clinicians, payers and patients in making treatment decisions.