Cost-effectiveness analysis of dupilumab among patients with oral corticosteroid-dependent uncontrolled severe asthma in Japan.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2022-11-01 Epub Date: 2021-12-08 DOI:10.1080/02770903.2021.1996596
Yuji Tohda, Hisako Matsumoto, Masanori Miyata, Yurie Taguchi, Maki Ueyama, Florence Joulain, Ichiro Arakawa
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引用次数: 5

Abstract

Background: Asthma is a common, chronic inflammatory airway disorder, with up to 1,177,000 people receiving asthma treatment in Japan. Dupilumab is a first-in-class, monoclonal antibody for the treatment of atopic diseases, including persistent asthma. The objective of this study was to assess the cost-effectiveness of dupilumab, compared with other biologics, as add-on treatment to background therapy in patients aged ≥12 years with uncontrolled, persistent asthma in Japan.

Methods: A life-time Markov cohort model was used to conduct cost-effectiveness analysis from the Japanese healthcare payer perspective with an annual discount rate of 2%. Dupilumab was compared with benralizumab and mepolizumab, and against omalizumab (as a hypothetical scenario). Inputs were informed by dupilumab clinical trials (VENTURE [NCT02528214] and QUEST [NCT02414854] trials), the literature, official Japanese sources and expert opinions.

Results: The base case results suggest that treatment with dupilumab leads to fewer severe exacerbations and increased life-years (LYs) and quality-adjusted LYs (QALYs) than benralizumab and mepolizumab. At a willingness-to-pay (WTP) threshold of ¥5,000,000 per QALY gained, dupilumab was the dominant strategy (lower cost, increased QALYs) versus benralizumab, and cost-effective versus mepolizumab with an incremental cost-effectiveness ratio (ICER) of ¥1,010,921 (US$9,190, US$1 = ¥110). Versus omalizumab, dupilumab was not cost-effective (ICER of ¥10,802,368 [US$98,203]).

Conclusions: In Japan, dupilumab, as an add-on to background therapy, is economically dominant compared with benralizumab, and cost-effective versus mepolizumab.

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dupilumab在日本口服皮质类固醇依赖的未控制的严重哮喘患者中的成本-效果分析
背景:哮喘是一种常见的慢性炎症性气道疾病,在日本有多达117.7万人接受哮喘治疗。Dupilumab是一种一流的单克隆抗体,用于治疗特应性疾病,包括持续性哮喘。本研究的目的是评估dupilumab与其他生物制剂相比作为背景治疗的附加治疗在日本年龄≥12岁的未控制的持续性哮喘患者中的成本效益。方法:采用终身马尔可夫队列模型,以年折现率2%的日本医疗保健支付者视角进行成本-效果分析。将Dupilumab与benralizumab和mepolizumab进行比较,并与omalizumab进行比较(作为假设情况)。输入信息由dupilumab临床试验(VENTURE [NCT02528214]和QUEST [NCT02414854]试验)、文献、日本官方资料和专家意见提供。结果:基本病例结果表明,与贝纳利珠单抗和美polizumab相比,dupilumab治疗导致更少的严重恶化,并增加了生命年(LYs)和质量调整LYs (QALYs)。在每个获得的QALY的支付意愿(WTP)阈值为500万日元时,与贝纳利珠单抗相比,杜比单抗是主要策略(成本更低,QALY增加),与美波利珠单抗相比,成本效益更高,增量成本效益比(ICER)为1,010,921日元(9,190美元,1美元= 110日元)。与omalizumab相比,dupilumab不具有成本效益(ICER为10,802,368日元[98,203美元])。结论:在日本,与贝纳利珠单抗相比,dupilumab作为背景治疗的附加疗法在经济上占主导地位,与美波利珠单抗相比具有成本效益。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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