Introduction:The advent of  omalizumab(OML) had a major impact on the management of severe allergic asthma, however it has a very high cost.

Aims:To evaluate the cost-effectiveness of standard-of-care treatment(SoC) to SoC+omalizumab (OML+Soc) in patients with severe asthma using real-world prospective clinical data. 

Methods:A total of 206 patients with severe astma, including 126 of whom were in the OML+SoC group and 80 in the SoC group, were followed for 12 months to evaluate their asthma status and quality of life. Cost data for this patient-level economic evaluations were sourced from the database of the hospitals and expressed in Turkish Lira(?). Efficacy data were obtained by Asthma Control Test for asthma status, and the 5-level EQ-5D-5L version and the Asthma Quality of Life Scale for quality of life. A Markov model with 2-week cycles was specified, comparing costs and treatment effects of SoC vs OML+SoC over a lifetime from the Turkish payer perspective.

Results:Per-patient costs were ?23,607.08 in the SoC arm and ?425,329.81 in the OML+Soc arm, for a difference of ?401,722.74. Life years(LY) and quality-adjusted life years(QALY) were 13.60 and 10.08, respectively, in the SoC group; and 21.26 and 13.35, respectively, in the OML+SoC group, for differences of 7.66 LYs and 3.27 QALYs. This yielded an incremental cost-effectiveness ratio of an additional ?52,427.04 to gain 1 LY and an incremental cost-utility ratio of an incremental ?122,675.57 to gain 1 QALY; the latter being below the ?156,948 willingness-to-pay threshold for Turkey referenced by WHO.

Conclusion:This data suggests that OML+SoC is cost-effective for severe asthma from the public payer perspective