IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0146003.html
   My bibliography  Save this article

Cost-Effectiveness of Bronchial Thermoplasty, Omalizumab, and Standard Therapy for Moderate-to-Severe Allergic Asthma

Author

Listed:
  • Zafar Zafari
  • Mohsen Sadatsafavi
  • Carlo A Marra
  • Wenjia Chen
  • J Mark FitzGerald

Abstract

Background: Bronchial thermoplasty (BT) is a recently developed treatment for patients with moderate-to-severe asthma. A few studies have suggested the clinical efficacy of this intervention. However, no study has evaluated the cost-effectiveness of BT compared to other alternative treatments for moderate-to-severe allergic asthma, which currently include omalizumab and standard therapy. Objective: To evaluate the cost-effectiveness of standard therapy, BT, and omalizumab for moderate-to-severe allergic asthma in the USA. Methods: A probabilistic Markov model with weekly cycles was developed to reflect the course of asthma progression over a 5-year time horizon. The study population was adults with moderate-to-severe allergic asthma whose asthma remained uncontrolled despite using high-dose inhaled corticosteroids (ICS, with or without long-acting beta-agonists [LABA]). A perspective of the health-care system was adopted with asthma-related costs as well as quality-adjusted life years (QALYs) and exacerbations as the outcomes. Results: For standard therapy, BT, and omalizumab, the discounted 5-year costs and QALYs were $15,400 and 3.08, $28,100 and 3.24, and $117,000 and 3.26, respectively. The incremental cost-effectiveness ratio (ICER) of BT versus standard therapy and omalizumab versus BT was $78,700/QALY and $3.86 million/QALY, respectively. At the willingness-to-pay (WTP) of $50,000/QALY and $100,000/QALY, the probability of BT being cost-effective was 9%, and 67%, respectively. The corresponding expected value of perfect information (EVPI) was $155 and $1,530 per individual at these thresholds. In sensitivity analyses, increasing the costs of BT from $14,900 to $30,000 increased its ICER relative to standard therapy to $178,000/QALY, and decreased the ICER of omalizumab relative to BT to $3.06 million/QALY. Reducing the costs of omalizumab by 25% decreased its ICER relative to BT by 29%. Conclusions: Based on the available evidence, our study suggests that there is more than 60% chance that BT becomes cost-effective relative to omalizumab and standard therapy at the WTP of $100,000/QALY in patients with moderate-to-severe allergic asthma. However, there is a substantial uncertainty in the underlying evidence, indicating the need for future research towards reducing such uncertainty.

Suggested Citation

  • Zafar Zafari & Mohsen Sadatsafavi & Carlo A Marra & Wenjia Chen & J Mark FitzGerald, 2016. "Cost-Effectiveness of Bronchial Thermoplasty, Omalizumab, and Standard Therapy for Moderate-to-Severe Allergic Asthma," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-15, January.
  • Handle: RePEc:plo:pone00:0146003
    DOI: 10.1371/journal.pone.0146003
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0146003
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0146003&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0146003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Tsuchiya, A & Brazier, J & McColl, E & Parkin, D, 2002. "Deriving preference-based single indices from non-preference based condition-specific instruments: converting AQLQ into EQ5D indices," MPRA Paper 29740, University Library of Munich, Germany.
    2. Kelvin K. W. Chan & Andrew R. Willan & Michael Gupta & Eleanor Pullenayegum, 2014. "Underestimation of Uncertainties in Health Utilities Derived from Mapping Algorithms Involving Health-Related Quality-of-Life Measures," Medical Decision Making, , vol. 34(7), pages 863-872, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Carlos E. Rodriguez-Martinez & Monica P. Sossa-Briceño & Jose A. Castro-Rodriguez, 2018. "Cost Effectiveness of Pharmacological Treatments for Asthma: A Systematic Review," PharmacoEconomics, Springer, vol. 36(10), pages 1165-1200, October.
    2. R. Brett McQueen & Danielle N. Sheehan & Melanie D. Whittington & Job F. M. Boven & Jonathan D. Campbell, 2018. "Cost-Effectiveness of Biological Asthma Treatments: A Systematic Review and Recommendations for Future Economic Evaluations," PharmacoEconomics, Springer, vol. 36(8), pages 957-971, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brazier, JE & Yang, Y & Tsuchiya, A, 2008. "A review of studies mapping (or cross walking) from non-preference based measures of health to generic preference-based measures," MPRA Paper 29808, University Library of Munich, Germany.
    2. Billingsley Kaambwa & Julie Ratcliffe, 2018. "Predicting EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) Utilities from Older People’s Quality of Life Brief Questionnaire (OPQoL-Brief) Scores," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 11(1), pages 39-54, February.
    3. Billingsley Kaambwa & Gang Chen & Julie Ratcliffe & Angelo Iezzi & Aimee Maxwell & Jeff Richardson, 2017. "Mapping Between the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and Five Multi-Attribute Utility Instruments (MAUIs)," PharmacoEconomics, Springer, vol. 35(1), pages 111-124, January.
    4. Krishnakumar Thankappan & Tejal Patel & Krishna Kollamparambil Ajithkumar & Deepak Balasubramanian & Manu Raj & Sujha Subramanian & Subramania Iyer, 2022. "Mapping of head and neck cancer patient concerns inventory scores on to Euroqol-Five Dimensions-Five Levels (EQ-5D-5L) health utility scores," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 225-235, March.
    5. Kamran Khan & Stavros Petrou & Oliver Rivero-Arias & Stephen Walters & Spencer Boyle, 2014. "Mapping EQ-5D Utility Scores from the PedsQL™ Generic Core Scales," PharmacoEconomics, Springer, vol. 32(7), pages 693-706, July.
    6. Rowen, D & Brazier, J & Tsuchiya, A & Hernández, M & Ibbotson, R, 2009. "The simultaneous valuation of states from multiple instruments using ranking and VAS data: methods and preliminary results," MPRA Paper 29841, University Library of Munich, Germany.
    7. Samer A. Kharroubi & Richard Edlin & David Meads & Chantelle Browne & Julia Brown & Christopher McCabe, 2015. "Use of Bayesian Markov Chain Monte Carlo Methods to Estimate EQ-5D Utility Scores from EORTC QLQ Data in Myeloma for Use in Cost-Effectiveness Analysis," Medical Decision Making, , vol. 35(3), pages 351-360, April.
    8. Jeff Round & Annie Hawton, 2017. "Statistical Alchemy: Conceptual Validity and Mapping to Generate Health State Utility Values," PharmacoEconomics - Open, Springer, vol. 1(4), pages 233-239, December.
    9. Jihyung Hong & Eun-Young Bae, 2021. "A Review of Utility Measurement Methods Used in Pharmacoeconomic Submissions to HIRA in South Korea: Methodological Consistency and Areas for Improvement," PharmacoEconomics, Springer, vol. 39(10), pages 1109-1121, October.
    10. Donna Rowen & John Brazier & Aki Tsuchiya & Mónica Hernández Alava, 2012. "Valuing states from multiple measures on the same visual analogue sale: a feasibility study," Health Economics, John Wiley & Sons, Ltd., vol. 21(6), pages 715-729, June.
    11. John Brazier & Yaling Yang & Aki Tsuchiya & Donna Rowen, 2010. "A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 215-225, April.
    12. Matthijs M. Versteegh & Annemieke Leunis & Jolanda J. Luime & Mike Boggild & Carin A. Uyl-de Groot & Elly A. Stolk, 2012. "Mapping QLQ-C30, HAQ, and MSIS-29 on EQ-5D," Medical Decision Making, , vol. 32(4), pages 554-568, July.
    13. Yaling Yang & John E. Brazier & Aki Tsuchiya & Tracey A. Young, 2011. "Estimating a Preference-Based Index for a 5-Dimensional Health State Classification for Asthma Derived from the Asthma Quality of Life Questionnaire," Medical Decision Making, , vol. 31(2), pages 281-291, March.
    14. Nick Kontodimopoulos & Panagiotis Bozios & John Yfantopoulos & Dimitris Niakas, 2013. "Longitudinal predictive ability of mapping models: examining post-intervention EQ-5D utilities derived from baseline MHAQ data in rheumatoid arthritis patients," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 307-314, April.
    15. Matthew Franklin & Katherine Payne & Rachel A. Elliott, 2018. "Quantifying the Relationship between Capability and Health in Older People: Can’t Map, Won’t Map," Medical Decision Making, , vol. 38(1), pages 79-94, January.
    16. Christine Mpundu-Kaambwa & Gang Chen & Remo Russo & Katherine Stevens & Karin Dam Petersen & Julie Ratcliffe, 2017. "Mapping CHU9D Utility Scores from the PedsQLTM 4.0 SF-15," PharmacoEconomics, Springer, vol. 35(4), pages 453-467, April.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0146003. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.