Cost-effectiveness analysis of dupilumab among patients with uncontrolled severe asthma using LIBERTY ASTHMA QUEST Korean data

초록

BackgroundA sub-analysis of the Korean population in the LIBERTY ASTHMA QUEST trial (NCT02414854) revealed that dupilumab effectively treated severe uncontrolled asthma. This study aimed to assess the cost-effectiveness of add-on therapy with dupilumab to background therapy in patients >= 12 years of age with uncontrolled severe asthma compared to that of background therapy in South Korea.MethodsThe cost-effectiveness analysis was conducted using a Markov model over a lifetime from the Korean healthcare system perspective. Clinical efficacy and utility weights were obtained from post-hoc analyses of the Korean population in the QUEST trial. Data on the costs and treatment setting of exacerbation in a real-world setting were retrospectively collected using the administrative medical database from a single tertiary hospital.ResultsThe base-case results indicated that add-on dupilumab therapy increases costs ($112,924foradd-ondupilumabversus$29,545 for background therapy alone). However, add-on dupilumab increased quality-adjusted life years (QALYs, 8.03 versus 3.93, respectively), with fewer events of severe exacerbations per patient compared to using the background therapy alone (17.920 versus 19.911, respectively). The incremental cost-effectiveness ratio was $20,325perQALY.Varioussensitivityanalysessupportedtherobustnessofthebase-caseresults.Probabilisticsensitivityanalysisshowedthattheprobabilityofadd-ondupilumabbeingcost-effectivewas87$26,718 (KRW 35 million) per QALY gained.ConclusionsDupilumab is cost-effective for adolescents and adults with uncontrolled severe asthma in South Korea. Our study provides evidence to support clinicians and policymakers in making informed decisions for severe asthma management.

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