Incremental net monetary benefit of biologic therapies in moderate to severe asthma: a systematic review and meta-analysis of economic evaluation studies
1
Issued Date
2023-01-01
Resource Type
ISSN
02770903
eISSN
15324303
Scopus ID
2-s2.0-85150856255
Pubmed ID
36825403
Journal Title
Journal of Asthma
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Asthma (2023)
Suggested Citation
Veettil S.K., Vincent V., Shufelt T., Behan E., Syeed M.S., Thakkinstian A., Young D.C., Chaiyakunapruk N. Incremental net monetary benefit of biologic therapies in moderate to severe asthma: a systematic review and meta-analysis of economic evaluation studies. Journal of Asthma (2023). doi:10.1080/02770903.2023.2183407 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82716
Title
Incremental net monetary benefit of biologic therapies in moderate to severe asthma: a systematic review and meta-analysis of economic evaluation studies
Other Contributor(s)
Abstract
Objectives: This meta-analysis was conducted to quantitatively pool the incremental net benefit (INB) of using biologic therapies as an add-on treatment to standard therapy in patients with moderate to severe asthma. Methods: We performed a comprehensive search in several databases published until April 2022. Studies were included if they were cost-effectiveness analyses reporting cost per quality-adjusted life-year or life-year on any biologic therapies as an add-on treatment for moderate to severe asthma in patients of all ages. Various monetary units were converted to purchasing power parity, adjusted to 2021 US dollars. The INBs were pooled across studies using a random-effects model, stratified by country income level (high-income countries (HICs) and low- and middle-income countries (LMICs)) and perspectives (health care or payer perspective (HCPP) and societal perspective (SP)) and age group (>12 years and 6–11 years). Heterogeneity was assessed using the I2 statistic. Results: A total of 32 comparisons from 25 studies were included. Pooled INB indicated that the use of omalizumab as an add-on treatment to standard therapy in those aged >12 years was not cost-effective in HICs from the HCPP (n = 8, INB, −6,341 (95% CI, -$25,000 to $12,210), I2=86.18%) and SP (n = 5, -$14,000 (-$170,000 to $140,000), I2=75.64%). A similar finding was observed in those aged 6–11 years from the HCPP in LMICs (n = 2, -$45,000 (-$73,000 to $17,000), I2=00.00%). Subgroup analyses provided no explanations of the potential sources of heterogeneity. Conclusion: The use of biologic therapies in moderate to severe asthma is not cost-effective compared to standard treatment alone.