[Pharmacoeconomic evaluation of preseasonal treatment of omalizumab in seasonal allergic rhinitis].

Abstract

Objective: To assess the pharmacoeconomic benefits of using omalizumab in the treatment of seasonal allergic rhinitis (SAR) before the pollen season. Methods: This economic evaluation, which based on a prospective, randomized, controlled, open label, single center trial conducted in 2020, compared omalizumab treatment with standard medicine treatment in controlling SAR symptoms two weeks before autumn pollen season. Total nasal symptom scores (TNSS) were used as the effect index for cost-effectiveness analysis (CEA), with incremental cost-effectiveness ratio (ICER) calculated. Cost-utility analysis (CUA) was used to compare incremental cost-utility ratios (ICUR) between groups using 1.76 times of the national and Beijing per capita GDP as willingness-to-pay thresholds. The experimental group was divided into mild and moderate-severe groups for cost-effectiveness analysis. Results: CEA showed an ICER of 3 084.76 yuan/point. CUA revealed an ICUR of 554 288.39 yuan, exceeding 1.76 times of the 2020 national (126 417.28 yuan) and Beijing (288 918.08 yuan) per capita GDP. Therefore, omalizumab currently lacked economic advantage in both Beijing and nationwide. The moderate-severe subgroup had a lower ICUR (371 041.07 yuan/year) than the mild subgroup (1 436, 823.35 yuan/year). Omalizumab would gain economic advantage in Beijing if its cost dropped below 723.02 yuan/dose, and nationwide below 312.72 yuan/dose. For moderate-severe patients, the cost threshold for Beijing was 1 104.95 yuan/dose, and 482.45 yuan/dose nationwide. Conclusions: At its current price, a single pre-pollen season omalizumab injection (300 mg) offers no pharmacoeconomic advantage over conventional medication in improving SAR patients' quality of life in Beijing and nationwide. However, omalizumab shows lower ICUR in moderate-severe SAR patients compared to mild cases.