ABSTRACT

Introduction

Benralizumab, amonoclonal antibody for human interleukin-5, has been associated with adecrease in asthma exacerbations. The introduction of this drug raises concerns about the economic impact in scenarios with constraints. This study aimed to estimate the cost-utility of benralizumab plus standard care (SoC) vs. SoC alone in adults with severe uncontrolled asthma with evidence of eosinophilic phenotype.

Methods

We constructed aMarkov model with three health states (asthma on benralizumab and SOC, asthma on SOC alone, and death) from ahealthcare system perspective over alifetime horizon. The model was populated using local costs while utilities were derived from international literature. Cost and transition probabilities were obtained from amixture of Colombian-specific and internationally published data.

Results

The incremental cost-effectiveness ratio (ICER) per patient peryear was $US 42,746per QALY gained. Benralizumab treatment would be cost-effective at the recommended societal US 18,000 WTP threshold if the cost of benralizumab is reduced by 41% more than the base case value.

Conclusion

Benralizumab is not cost-effective using WTP of US$18,000per QALY threshold in Colombia. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines.

中文翻译：

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贝那利珠单抗作为哥伦比亚重症嗜酸性粒细胞哮喘标准护理的附加疗法的成本效用分析和预算影响

摘要

介绍

Benralizumab 是人白介素 5 的单克隆抗体，与哮喘恶化的减少有关。这种药物的引入引起了人们对在有限制的情况下的经济影响的担忧。本研究旨在评估 Benralizumab 加标准治疗 (SoC) 与 SoC 单独治疗患有严重未控制哮喘且有嗜酸性粒细胞表型证据的成人的成本效用。

方法

我们从医疗保健系统的角度构建了一个马尔可夫模型，其中包含三种健康状态（贝那利珠单抗和 SOC 引起的哮喘、SOC 引起的哮喘和死亡）。该模型使用当地成本进行填充，而公用事业则来自国际文献。成本和过渡概率是从哥伦比亚特定数据和国际公布的数据的混合中获得的。

结果

每名患者每年的增量成本效益比 (ICER) 为 42,746 美元/QALY。如果贝那利珠单抗的成本比基本案例值降低 41%，那么贝那利珠单抗治疗在推荐的社会 US 18,000 WTP 阈值下将具有成本效益。

结论

Benralizumab 在哥伦比亚使用每 QALY 阈值 18,000 美元的 WTP 并不具有成本效益。我们的研究提供了决策者应该用来改进临床实践指南的证据。