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PRS50 Benralizumab for treating severe eosinophilic asthma: nice single technology appraisal

PRS50 Benralizumab for treating severe eosinophilic asthma: nice single technology appraisal
PRS50 Benralizumab for treating severe eosinophilic asthma: nice single technology appraisal
Objectives
To critically review evidence on clinical and cost effectiveness of benralizumab (Fasenra®) in adults with severe eosinophilic asthma, submitted by AstraZeneca to the National Institute for Health and Care Excellence (NICE).

Methods
AstraZeneca proposed a Markov model with a two-week cycle length and a lifetime time horizon. Benralizumab in combination with standard of care (SOC) was compared with mepolizumab+SOC, reslizumab+SOC and SOC alone in people with a blood eosinophil count of ≥300 cells/microliter, who had had ≥3 exacerbations in previous year or maintenance oral corticosteroids over previous six months. SIROCCO, CALIMA and ZONDA randomised control trials informed the comparison of benralizumab versus SOC. The clinical effectiveness of benralizumab compared with mepolizumab was based on a matched-adjusted indirect comparison analysis. In benralizumab versus reslizumab analysis, the treatments were assumed to be equally effective. The perspective was of the UK National Health Service and Personal Social Services. Costs and benefits were discounted at 3.5% per year. The company offered a Patient Access Scheme (PAS).

Results
The NICE committee noted that some people within the population considered by the company would be eligible for treatment with mepolizumab or reslizumab, and therefore the mixed population was not suitable for making decisions about the cost effectiveness of benralizumab relative to SOC. In an additional analysis for people not eligible for biologicals, the company’s and Evidence Review Group’s (ERG’s) incremental cost-effectiveness ratios (ICERs) for benralizumab versus SOC were £38,304 and £45,406 per quality-adjusted life-year (QALY) gained, respectively. In the ERG’s analysis for benralizumab versus mepolizumab in the mepolizumab-eligible population, the ICER, under PAS prices for the drugs, was below £20,000/QALY gained. In the reslizumab-eligible population, assuming PAS prices for benralizumab and reslizumab and clinical equivalence of these treatments, benralizumab was cost saving.

Conclusions
Benralizumab is recommended by NICE in people with severe asthma eligible either for mepolizumab or reslizumab.
1098-3015
S358-S358
Tikhonova, I.
577ccbcc-6643-4190-bb6d-19e13b44bcd1
Long, L.
334ae7a0-f444-464f-90a6-4f9dd1cf6ead
Ocean, N.
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Barnish, M.
980cc50f-29e9-4c85-899f-b0879baeeea3
Robinson, S.
ba591c98-4380-456a-be8a-c452f992b69b
Nikram, E.
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Bello, S.
dfa8b496-cb08-4b96-9e1f-f7332bf81e1c
Dodman, S.
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Hoyle, M.
ebc06a93-bd41-4c23-8c96-1d9e74512c38
Tikhonova, I.
577ccbcc-6643-4190-bb6d-19e13b44bcd1
Long, L.
334ae7a0-f444-464f-90a6-4f9dd1cf6ead
Ocean, N.
35e343ee-3c39-4b67-94b8-1ab6c6ba8665
Barnish, M.
980cc50f-29e9-4c85-899f-b0879baeeea3
Robinson, S.
ba591c98-4380-456a-be8a-c452f992b69b
Nikram, E.
3d92f61e-25cb-421f-9957-8c926d35df25
Bello, S.
dfa8b496-cb08-4b96-9e1f-f7332bf81e1c
Dodman, S.
1e54cc1d-5fa2-4c39-bdfd-4a18361e3f8a
Hoyle, M.
ebc06a93-bd41-4c23-8c96-1d9e74512c38

Tikhonova, I., Long, L., Ocean, N., Barnish, M., Robinson, S., Nikram, E., Bello, S., Dodman, S. and Hoyle, M. (2019) PRS50 Benralizumab for treating severe eosinophilic asthma: nice single technology appraisal. Value in Health, 22 (Supplement 2), S358-S358. (doi:10.1016/j.jval.2019.04.1754).

Record type: Meeting abstract

Abstract

Objectives
To critically review evidence on clinical and cost effectiveness of benralizumab (Fasenra®) in adults with severe eosinophilic asthma, submitted by AstraZeneca to the National Institute for Health and Care Excellence (NICE).

Methods
AstraZeneca proposed a Markov model with a two-week cycle length and a lifetime time horizon. Benralizumab in combination with standard of care (SOC) was compared with mepolizumab+SOC, reslizumab+SOC and SOC alone in people with a blood eosinophil count of ≥300 cells/microliter, who had had ≥3 exacerbations in previous year or maintenance oral corticosteroids over previous six months. SIROCCO, CALIMA and ZONDA randomised control trials informed the comparison of benralizumab versus SOC. The clinical effectiveness of benralizumab compared with mepolizumab was based on a matched-adjusted indirect comparison analysis. In benralizumab versus reslizumab analysis, the treatments were assumed to be equally effective. The perspective was of the UK National Health Service and Personal Social Services. Costs and benefits were discounted at 3.5% per year. The company offered a Patient Access Scheme (PAS).

Results
The NICE committee noted that some people within the population considered by the company would be eligible for treatment with mepolizumab or reslizumab, and therefore the mixed population was not suitable for making decisions about the cost effectiveness of benralizumab relative to SOC. In an additional analysis for people not eligible for biologicals, the company’s and Evidence Review Group’s (ERG’s) incremental cost-effectiveness ratios (ICERs) for benralizumab versus SOC were £38,304 and £45,406 per quality-adjusted life-year (QALY) gained, respectively. In the ERG’s analysis for benralizumab versus mepolizumab in the mepolizumab-eligible population, the ICER, under PAS prices for the drugs, was below £20,000/QALY gained. In the reslizumab-eligible population, assuming PAS prices for benralizumab and reslizumab and clinical equivalence of these treatments, benralizumab was cost saving.

Conclusions
Benralizumab is recommended by NICE in people with severe asthma eligible either for mepolizumab or reslizumab.

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Published date: May 2019

Identifiers

Local EPrints ID: 438184
URI: http://eprints.soton.ac.uk/id/eprint/438184
ISSN: 1098-3015
PURE UUID: 2769aaa3-5ada-4b00-a237-2de5e4672790
ORCID for I. Tikhonova: ORCID iD orcid.org/0000-0003-2723-0802
ORCID for S. Robinson: ORCID iD orcid.org/0000-0003-1766-7269

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Date deposited: 04 Mar 2020 17:30
Last modified: 22 Jul 2022 23:20

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Contributors

Author: I. Tikhonova ORCID iD
Author: L. Long
Author: N. Ocean
Author: M. Barnish
Author: S. Robinson ORCID iD
Author: E. Nikram
Author: S. Bello
Author: S. Dodman
Author: M. Hoyle

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