Economic analysis of the phase III MENSA study evaluating mepolizumab for severe asthma with eosinophilic phenotype

Expert Rev Pharmacoecon Outcomes Res. 2017 Apr;17(2):121-131. doi: 10.1080/14737167.2017.1298444. Epub 2017 Mar 17.

Abstract

Background: Severe eosinophilic asthma patients are at risk of exacerbations, which are associated with substantial costs. Mepolizumab lowers eosinophil levels and reduces exacerbation risk in severe eosinophilic asthma. We evaluated asthma-related exacerbation costs in mepolizumab-treated patients (versus placebo).

Methods: A within-trial economic analysis of the Mepolizumab as Adjunctive Therapy in Patients with Severe Asthma (MENSA) trial. Objectives were to quantify the incremental: (1) medical costs of asthma-related exacerbation; (2) asthma-related exacerbation emergency department visit/hospitalization costs; and (3) asthma-related total healthcare resource utilization.

Results: Mean medical costs of asthma-related exacerbations at 8 months were $969, $852, and $1692 in the mepolizumab 75 mg intravenous (IV), mepolizumab 100 mg subcutaneous (SC), and placebo groups, respectively (p = 0.16). Mean medical costs from emergency department visits or hospitalizations due to asthma-related exacerbations were $901, $795, and $1557 in the mepolizumab 75 mg IV, mepolizumab 100 mg SC, and placebo groups (p = 0.020). Asthma-related healthcare resource utilization (all services) was lower for the mepolizumab groups versus placebo.

Conclusions: Adding mepolizumab to standard-of-care treatment for severe eosinophilic asthma lowered asthma exacerbation-related medical costs/healthcare resource utilization; although the cost savings ranged from $723-$840 per patient, differences were not statistically significant.

Keywords: Cost analysis; eosinophilic phenotype; exacerbation; mepolizumab; severe asthma.

Publication types

  • Clinical Trial, Phase III
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / economics
  • Anti-Asthmatic Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / economics
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / economics
  • Asthma / physiopathology
  • Child
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Emergency Service, Hospital / economics
  • Eosinophilia / drug therapy*
  • Eosinophilia / economics
  • Female
  • Health Care Costs
  • Hospitalization / economics
  • Humans
  • Injections, Subcutaneous
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Young Adult

Substances

  • Anti-Asthmatic Agents
  • Antibodies, Monoclonal, Humanized
  • mepolizumab