Summary
Background
Chronic spontaneous urticaria (CSU) is a skin disease, with itchy hives and / or angioedema that last for at least 6 weeks without an obvious external trigger.
Objectives
The objective of this study was to determine the cost-effectiveness of omalizumab relative to standard of care (SoC; up to 4 times the daily dose of H1-antihistaminics) for the Netherlands from a societal perspective.
Methods
The Markov model used consisted of five health states based on Urticaria Activity Score over seven days (UAS7). 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 EQ-5D) and productivity losses were derived from a burden of illness study (ASSURE-CSU) among 93 Dutch patients. Healthcare consumption and productivity losses were valued using the Dutch costing manual. Comparator treatment was SoC, consisting of (up dosed) antihistamines. A ten-year time horizon was used.
Results
The incremental cost-effectiveness ratio (ICER) of omalizumab versus 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 to SoC. The outcomes of this study were used to establish omalizumab as third-line treatment in the Dutch treatment guidelines for CSU.
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