The patient perspective on use of Omalizumab in the in-hospital setting.

Background: Omalizumab is approved for the treatment of chronic spontaneous urticaria (CSU), allergic asthma, and chronic rhinosinusitis with nasal polyps. While self-administration is licensed in Ireland, reimbursement restrictions require hospital-based delivery, placing significant burdens on patients and healthcare services.

Aims: To evaluate patient perspectives on hospital-based administration of Omalizumab, and assess the practical, financial, and environmental implications of current practices, alongside interest in transitioning to home-based therapy.

Methods: A cross-sectional survey was conducted among patients receiving Omalizumab in a tertiary referral hospital between December 2024 and January 2025. Eligible participants (n=49) completed a 20- question anonymous questionnaire exploring demographics, treatment burden, and attitudes toward home therapy. Cost data were obtained from institutional finance records.

Results: Among 49 respondents (98% response rate), 46.9% reported personal costs of €11-€50 per hospital visit, with some incurring over €1,300 annually. Over one quarter (26.5%) missed more than 11 workdays per year due to treatment. Most travelled by private vehicle, generating an estimated 2.1 tonnes of CO₂ annually. A majority (77.5%) would prefer home therapy, citing convenience, flexibility, and reduced financial burden. Annual institutional costs for hospital-based administration of Omalizumab exceeded €1 million, excluding drug expenditure.

Conclusions: Hospital-based administration of Omalizumab imposes significant patient and system-level costs. These findings support a transition to reimbursed self-administration at home, which may improve patient satisfaction, reduce absenteeism, minimise environmental impact, and achieve considerable healthcare savings.