Background and importance Therapeutic growth in the arsenal of drugs for the treatment of severe asthma (SA) with similar efficacy profiles, safety and mechanisms of action requires multidisciplinary treatment protocols to maintain the sustainability of the health systems. The last therapeutic positioning report, published in January 2019, found that the choice between benralizumab, reslizumab or mepolizumab in patients with SA and eosinophilia should be based on efficiency criteria.
In addition, when SA is mediated by IgE and eosinophilia, the patient would also be a candidate for omalizumab.
Aim and objectives To analyse the annual expenditure in our hospital for the treatment of SA with omalizumab and estimate the potential savings that could be generated by applying a multidisciplinary treatment protocol, choosing the most efficient alternative.
Material and methods This was a retrospective unicentric study of 1 year (January–December 2018) in which all patients treated with omalizumab by the pneumology department were analysed. All patients with SA were treated with omalizumab.
For the economic analysis, only patients with IgE mediated SA and eosinophilia >300 cells/μL were considered.
The estimated annual cost was calculated based on the dosage of omalizumab and compared with the estimated annual cost applying the protocol, which indicated that for treatment of IgE mediated SA and eosinophilia >300 cells/μL, the drug used would be selected according to efficiency criteria.
The variables collected were weight, dosage and level of IgE and eosinophils at the start of treatment. The SAP application was used for data extraction. Costs were calculated from the sales price of the laboratory (PVL) applying the Spanish Royal Decree discount (−7.5%) and the discount offered to the hospital.
Results A total of 65 patients were analysed, 71% (46) of whom met the criteria for IgE mediated SA and eosinophilia >300 cells/μL.
Median patient weight was 74.5 kg (45–120), median IgE was 219.5 IU/mL (46–1500) and median eosinophils were 630 cells/μL (310–1783).
The estimated annual cost according to the dosage for omalizumab was 582 541.95€ while the cost applying the treatment protocol by efficiency criteria was 384 945.81€, an annual saving of 197 596.14€.
Conclusion and relevance Multidisciplinary protocols allow strengthening of partnerships between hospital departments, improve best health outcomes and maintain economic sustainability.
References and/or acknowledgements No conflict of interest.
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