Cost-utility analysis of dupilumab vs omalizumab in the treatment of severe asthma

XU Nuo-ming; JIANG Xin-yue; HE Xiao-ning

doi:10.20251/j.cnki.1003-3734.2025.19.013

Abstract：Objective:To evaluate the cost-effectiveness of dupilumab plus background therapy compared with omalizumab plus background therapy in the treatment of severe asthma from the perspective of Chinese health system.Methods:A Markov model was established.The clinical efficacy,health benefit and cost data were obtained from the randomized controlled trials,published literatures and clinical expert consultation results.Lifetime disease outcomes,effectiveness,and costs under each intervention were calculated.With incremental cost-effectiveness ratio(ICER)as the index,the economy of each intervention was evaluated under the threshold of 2 times GDP per capita(178 716 yuan in 2023).Scenario analysis,one way sensitivity analysis and probability sensitivity analysis were carried out to verify the robustness of the results.Results:The total costs were 679 459 and 615 213 CNY in the groups of dupilumab and omalizumab,respectively.Total quality-adjusted life year(QALY)were 13.11 and 12.68.Compared with omalizumab,dupilumab increased costs by 64 246 CNY and QALY by 0.43.ICER was 149661 CNY per QALY,which was lower than the 2 times per-capita GDP threshold,indicating that dupilumab was cost-effective compared with omalizumab.In the two scenarios set in the study,the group of dupilumab was more economical than the group of omalizumab.In the three scenarios set in the study,the group of dupilumab was more economical.If the negotiated price of dupilumab in the 2024 edition of the National Medical Insurance Drug List is used,the group of dupilumab is obviously superior.Sensitivity analysis verified the robustness of the above results.Conclusion:Under the threshold of 2-time Chinese GDP per capita,dupilumab is more cost-effective than omalizumab in the treatment of severe asthma patients.