Cost-effectiveness analysis of biologics for the treatment of chronic rhinosinusitis with nasal polyps in Canada

Allergy, Asthma & Clinical Immunology

Research

Martin Y. Desrosiers¹  Shaun J. Kilty²  Andrew Thamboo³  Michael Yong³  Keshinisuthan Kirubalingam⁴ 

[1] Department of Otolaryngology, Centre de Recherche du Centre Hospitalier de L’Universite de Montreal, Montreal, QC, Canada;Department of Otolaryngology, Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada;Division of Otolaryngology, Head and Neck Surgery, University of British Columbia Faculty of Medicine, 1081 Burrard Street, V5Z 1Y6, Vancouver, BC, Canada;Faculty of Medicine, Queen’s University, Kingston, ON, Canada;

关键词: Cost-effectiveness;    Biologics;    Chronic Rhinosinusitis;    Nasal Polyps;   

DOI  :  10.1186/s13223-023-00823-1

 received in 2022-08-31, accepted in 2023-07-13,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDupilumab, omalizumab, and mepolizumab are the three biologics currently approved for use in CRSwNP in Canada. Despite evidence of efficacy, their cost-effectiveness, which is a key factor influencing prescribing patterns, has not yet been compared to each other.MethodsA cost-effectiveness model using quality-adjusted life years (QALYs) was constructed using a Decision Tree Markov analysis. A third-party healthcare payer perspective and a 10-year time horizon was used. A willingness-to-pay (WTP) threshold of 50,000 Canadian dollars (CAD) per QALY was used to determine cost-effectiveness. Dupilumab, omalizumab, and mepolizumab were each compared to each other.ResultsOmalizumab was the most cost-effective biologic using current estimates of cost and efficacy in CRSwNP. Using omalizumab as a baseline, dupilumab had an ICER of $235,305/QALY. Mepolizumab was dominated by omalizumab and dupilumab at the current drug prices and estimates of efficacy. Sensitivity analyses determined that when increasing the WTP threshold to $150,000/QALY, dupilumab became cost-effective compared to omalizumab in 22.5% of simulation scenarios. Additionally, altering dosing frequency had a significant effect on cost-effectiveness.ConclusionWhen comparing the relative cost-effectiveness of biologics in recalcitrant CRSwNP, omalizumab currently appears to be the most cost-effective option. Future reductions in drug prices, adjustments to currently approved dosing regimens, better patient selection, and improvements in sinus surgery outcomes will challenge the current cost-effectiveness models and necessitate reassessment as treatments for CRSwNP continue to evolve.

【 授权许可】

CC BY   
© Canadian Society of Allergy & Clinical Immunology 2023

【 图 表 】

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