World Allergy Organization Journal (Feb 2021)

Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

  • Diego Bagnasco,
  • Massimiliano Povero,
  • Lorenzo Pradelli,
  • Luisa Brussino,
  • Giovanni Rolla,
  • Marco Caminati,
  • Francesco Menzella,
  • Enrico Heffler,
  • Giorgio Walter Canonica,
  • Pierluigi Paggiaro,
  • Gianenrico Senna,
  • Manlio Milanese,
  • Carlo Lombardi,
  • Caterina Bucca,
  • Andrea Manfredi,
  • Rikki Frank Canevari,
  • Giovanni Passalacqua,
  • Gabriella Guarnieri,
  • Vincenzo Patella,
  • Foschino Barbaro Maria Pia,
  • Elisiana Carpagnano,
  • Anna del Colle,
  • Giulia Scioscia,
  • Pelaia Gerolamo,
  • Pierluigi Paggiaro,
  • Manuela Latorre,
  • Francesca Puggioni,
  • Francesca Racca,
  • Elisabetta Favero,
  • Sandra Iannacone,
  • Eleonora Savi,
  • Marcello Montagni,
  • Gianna Camiciottoli,
  • Chiara Allegrini,
  • Giuseppe Spadaro,
  • Caterina Detoraki,
  • Carla Galeone,
  • Patrizia Ruggiero,
  • Monna Rita Yacoub,
  • Alvise Berti,
  • Gisella Colombo,
  • Nicola Scichilone,
  • Carmen Durante,
  • Maria Teresa Costantino,
  • Chiara Roncallo,
  • Mariachiara Braschi,
  • Francesco Blasi,
  • Alice D'Adda,
  • Erminia Ridolo,
  • Massimo Triggiani,
  • Roberta Parente,
  • D'Amato Maria,
  • Maria Vittoria Verrillo,
  • Zappa Maria Cristina,
  • Marianna Lilli,
  • Nunzio Crimi,
  • Marco Bonavia,
  • Angelo Guido Corsico,
  • Amelia Grosso,
  • Stefano Del Giacco,
  • Margherita Deidda,
  • Luisa Ricciardi,
  • Stefania Isola,
  • Francesca Cicero,
  • Giuliana Amato,
  • Federica Vita,
  • Antonio Spanevello,
  • Patrizia Pignatti,
  • Francesca Cherubino,
  • Dina Visca,
  • Eleonora Aletti,
  • Fabio Luigi Massimo Ricciardolo,
  • Vitina Maria Anna Carriero,
  • Francesca Bertolini,
  • Pierachille Santus,
  • Roberta Barlassina,
  • Andrea Airoldi,
  • Giuseppe Guida,
  • Nucera Eleonora,
  • Arianna Aruanno,
  • Angela Rizzi,
  • Cristiano Caruso,
  • Stefania Colantuono,
  • Alessandra Arcolaci,
  • Andrea Vianello,
  • Fulvia Chieco Bianchi,
  • Maria Rita Marchi,
  • Stefano Centanni,
  • Simone Luraschi,
  • Silvia Ruggeri,
  • Rocco Rinaldo,
  • Elena Parazzini,
  • Cecilia Calabrese,
  • Martina Flora,
  • Lorenzo Cosmi,
  • Linda Di Pietro,
  • Enrico Maggi,
  • Laura Pini,
  • Luigi Macchia,
  • Danilo Di Bona,
  • Luca Richeldi,
  • Carola Condoluci,
  • Leonello Fuso,
  • Matteo Bonini,
  • Alessandro Farsi,
  • Giulia Carli,
  • Paolo Montuschi,
  • Giuseppe Santini,
  • Maria Elisabetta Conte,
  • Elisa Turchet,
  • Carlo Barbetta,
  • Francesco Mazza,
  • Simona D'Alo,
  • Stefano Pucci,
  • Maria Filomena Caiaffa,
  • Elena Minenna,
  • Luciana D'Elia,
  • Carlo Pasculli,
  • Vittorio Viviano,
  • Paolo Tarsia,
  • Joyce Rolo,
  • Mariacarmela Di Proietto,
  • Salvatore Lo Cicero,
  • Mariacarmela Di Proietto

Journal volume & issue
Vol. 14, no. 2
p. 100509

Abstract

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Background and aims: Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods: Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results: 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions: Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.

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