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Cost‐effectiveness of omalizumab for the treatment of chronic spontaneous urticaria
Author(s) -
Kanters T.A.,
Thio H.B.,
Hakkaart L.
Publication year - 2018
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.16476
Subject(s) - omalizumab , medicine , chronic urticaria , dermatology , intensive care medicine , immunoglobulin e , immunology , antibody
Summary Background Chronic spontaneous urticaria ( CSU ) is a skin disease with itchy hives and/or angio‐oedema that last for at least 6 weeks without an obvious external trigger. Objectives To determine the cost‐effectiveness of omalizumab relative to standard of care (SoC; up to four times the daily dose of H 1 ‐antihistamines) in the Netherlands from a societal perspective. Methods The Markov model used consisted of five health states based on Urticaria Activity Score over 7 days. Model settings and characteristics of the Dutch patient population were based on an online survey among clinical experts and were validated during an expert committee meeting. Transition probabilities were derived from the GLACIAL trial. Healthcare consumption, quality of life (using EuroQol‐5D) and productivity losses were derived from a burden‐of‐illness study ( ASSURE ‐ CSU ) among 93 Dutch patients. Healthcare consumption and productivity losses were evaluated using the Dutch costing manual. The comparator treatment was SoC, consisting of (updosed) antihistamines. A 10‐year time horizon was used. Results The incremental cost‐effectiveness ratio ( ICER ) of omalizumab vs. SoC was €17 502 per quality‐adjusted life‐year ( QALY ) gained. Productivity costs played an important role in the value of the ICER ; discarding productivity costs resulted in an ICER of €85 310 per QALY . Conclusions Omalizumab is cost‐effective compared with SoC. The outcomes of this study were used to establish omalizumab as third‐line therapy in the Dutch treatment guidelines for CSU .