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.

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

Caminati, Marco;Senna, Gianenrico;Manfredi, Andrea;
2021-01-01

Abstract

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.
2021
ACT, Asthma Control Test
Anti IL-5
CI, Confidence Intervals
COPD, chronic obstructive pulmonary disease
Comorbidities
FeNO, fractional nitric oxide
GERD, gastroesophageal reflux disease
ICS, inhaled corticosteroids
IQR, interquartile range
LABA, long acting beta 2 agonist
LAMA, long acting muscarinic antagonist
LOS, Length of stay
MEP, Mepolizumab
Mepolizumab
OCS
OCS, Oral Corticosteroids
OR, Odds Ratio
Pharmacoeconomics
RCTs, Randomized Controlled Trials
RR, Rate Ratio
SD, Standard Deviation
Severe asthma
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1038241
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