OMALIZUMAB FOR SEVERE PERSISTENT ALLERGIC ASTHMA IN CHILDREN

Omalizumab for the treatment of severe persistent allergic asthma in children aged 6-11: an assessment based on the manufacturer’s submission to NICE

Background

The aim of this NICE STA was to appraise the clinical and cost-effectiveness of omalizumab within its licensed indication for for the treatment of severe persistent allergic asthma in children aged 6 to 11 years with severe, persistent allergic Immunoglobulin E -mediated asthma whose condition remains uncontrolled despite best standard care with high dose inhaled corticosteroids and long acting beta-agonist. CRD researchers together with researchers from the Centre for Health Economics (CHE) comprised the Evidence Review Group for this STA. The work involved a detailed assessment of the manufacturer’s submission to NICE on the clinical and cost-effectiveness of omalizumab.

Findings

The ERG concluded that omalizumab appears to reduce clinically significant exacerbations but there was no evidence of improvement in daily symptoms, clinically significant severe (CSS) exacerbations or hospitalisation rates.  The main driver of cost-effectiveness was the reduction in asthma-related mortality associated with a reduction in CSS exacerbations.  As the number of CSS exacerbations avoided was low, as is asthma-related mortality in children, the potential small gain in quality adjusted life years associated with omalizumab was not sufficient to compensate the high treatment cost even under the most favourable scenario analyses.

Conducted by: Simon Walker1, Jane Burch2, Claire McKenna1, Kath Wright2, Susan Griffin1, Nerys Woolacott2

1. Centre for Reviews and Dissemination; 2. Centre for Health Economics, University of York

Further details

Project page on NIHR HTA Programme website

Related guidance

Commissioned to inform NICE Technology Appraisal Guidance: Omalizumab for the treatment of severe persistent allergic asthma in children aged 6-11. London: National Institute for Clinical Excellence; 2011

Publications

Burch J, Griffin S, McKenna C, Walker S, Paton J, Wright K, Woolacott N. Omalizumab for the treatment of severe and persistent asthma in children aged 6 to 11 years: A NICE Single Technology Appraisal. Pharmacoeconomics 2012; [Epub ahead of print]

Walker S, Burch J, McKenna C, Wright K, Griffin S, Woolacott N. Omalizumab for the treatment of severe persistent allergic asthma in children aged 6-11. a Single Technology Appraisal. Centre for Reviews and Dissemination and Centre for Health Economics. 2010

Walker S, Burch J, McKenna C, Wright K, Griffin S, Woolacott N. Omalizumab for the treatment of severe persistent allergic asthma in children aged 6–11 years. Single Technology Appraisals: A supplement to Health Technology Assessment Journal 2011;15(Suppl. 1):13-21

Funding

Commissioned by the NIHR HTA Programme in support of NICE's Single Technology Appraisal process.

NICE’s single technology appraisal (STA) process is specifically designed for the appraisal of a single product, device or other technology, with a single indication. The STA process normally covers new technologies and is designed to provide recommendations in the form of NICE guidance soon after the technology is introduced into the UK market. The principal evidence in the STA process is submitted by the manufacturer or sponsor of the technology.