Качественная клиническая практика (Aug 2019)
Cost-effectiveness analysis of the use of mepolizumab in omalizumab-resistant patients with severe asthma
Abstract
Objective. To determine the clinical and economic consequences of the drug mepolizumab in patients with severe bronchial asthma (SBA) and the ineff ectiveness of omalizumab. Methods. We conducted cost-eff ectiveness and budget impact analysis of the use of mepolizumab or omalizumab in omalizumab-refractory patients with SBA. Source of information about the eff ectiveness were the results of published clinical studies; the cost of drugs — maximum ex-works prices of manufacturers of vital and essential medicinal products and instructions for use of drugs; the cost of medical services — program of state guarantees of free medical assistance on the territory of the Russian Federation, as well as the coeffi cients of relative cost intensity for clinicalstatistical groups. Results. According to the results of a multicenter open study OSMO, the use of mepolizumab in patients with ineff ective omalizumab therapy led to a decrease in the frequency of clinically signifi cant exacerbations and exacerbations requiring hospitalization (1.18 and 0.19 cases / year, respectively) compared to 12 months before screening (3.26 and 0.63 events / year, respectively). Result of the cost analysis showed that switching to mepolizumab leads to signifi cant savings: the sum of direct medical costs was 865 217 and 1 666 401 RUB per patient per year, respectively. Budget impact analysis demonstrated savings in the CHI system in the treatment with mepolizumab within the analyzed cohort of patients (n=18) by 2.8 million rubles in the fi rst year and 12.7 million rubles in 5 years. Analysis of «missed opportunities» showed that the use of mepolizumab can allow to treat an additional 3 people for 1 year of therapy and 15 people for fi ve years of implementation of the analyzed drug. Conclusion. The use of mepolizumab in patients with SBA resistant to omalizumab, will reduce budget costs and will increase the eff ectiveness of treatment.
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