Evaluation of cost effectiveness of standard combined therapy and supplemental combined treatment use of omalizumab in asthmatic patients adults in four different hospitals in Ankara

Asthma affects approximately 358 million people worldwide and is a chronic disease that contributes significantly to the increase in health expenditures. Especially in cases where asthma cannot be controlled and severe asthma, the economic burden of the disease reaches greater dimensions, including social, psychological and health care costs. Many studies in the literature indicate that in severe asthma cases, the largest share in the cost item belongs to drugs. Among the reasons for the increase in drug costs is the high cost of biological agents, despite the high effectiveness of the treatment. In this context, the aim of the research is; to evaluate the cost-effectiveness of the use of omalizumab in addition the standard therapy in the treatment of patients diagnosed with severe asthma. The study was conducted in Gazi, Hacettepe, Ankara University Faculty of Medicine Hospitals and Atatürk Chest Diseases and Thoracic Surgery E.R.H in Ankara province, patients aged 16-80 years who were diagnosed with severe asthma, who received OML treatment in addition to ST and ST and accepted the study. Total 216 patients participating in the study were interviewed face-to-face between March 2018 and January 2020. The cost data obtained from the automation program of the hospitals were evaluated with the perspective of SGK. The effectiveness data of the study were obtained from the EQ-5D-5L, ACT and AQLQ scales. The Markov model was used for cost-effectiveness analysis and the results of the research were indicated by the incremantal cost-effectiveness ratio. Accordingly, the cost of ST in patients with severe asthma was ₺23.607,08, and the cost of omalizumab in addition to ST was ₺425.329,81 from the SSI perspective. According to this result, the ICER of OML+ST use was determined ₺122.675,57. The additional QALY was determined 3,27. Comparing patients with severe asthma who only used standard treatment with patients used OML+ST, the result showed that OML+ST was cost-effective, remaining below ₺156.948,00, which is accepted as the willingness to pay threshold for Turkey and referred to by WHO. As a result of the PSA analysis, the ICER was calculated ₺122.675,30 and the additional QALY was calculated 3,27. This result showed that ST+OML is cost effective even under uncertainty of parameters. In conclusion, the use of OML+ST in addition to ST in patients with severe asthma has been found to be cost-effective from the SSI perspective, and it is recommended to be used in these patients. Keywords Severe Asthma, Omalizumab, Standard Therapy, Cost Effectiveness, Economic Evaluation