• asthma;
  • cost-effectiveness;
  • economic burden;
  • omalizumab

Background:  The health, economic and societal burden of asthma is considerable, and is greatest in patients with severe asthma, particularly when inadequately controlled. Real-life studies that assess the effectiveness of treatment are of particular interest.

Methods:  We determined the incremental cost-effectiveness ratio (ICER) of adding omalizumab to standard therapy using data from the real-life 1-year randomized open-label study (ETOPA) and using Canada as a reference country. Only patients receiving high-dose ICS plus LABA were included in the analysis, reflecting the EU label for omalizumab. Costs and quality-adjusted life years (QALYs) gained were used to calculate the ICER for omalizumab (cost/QALY). Probabilistic sensitivity analysis was performed to determine the 95% confidence interval and one-sided sensitivity analyses were performed.

Results:  The base case lifetime analysis of standard therapy vs standard therapy plus add-on omalizumab for the first 5 years, gave an ICER of €31 209. Probabilistic sensitivity analysis indicated that the 95% confidence interval around the ICER was €27 739–€40 840. The ICER range for one-way sensitivity analyses was €23 762 without discounting to €66 443 without inclusion of asthma-related mortality.

Conclusions:  This study demonstrates that add-on omalizumab therapy is cost-effective in patients with severe persistent allergic asthma.