Background The economic benefits of achieving remission in severe eosinophilic asthma (SEA) are unknown. Methods Asthma-related healthcare resource and non-biologic medication use costs during the second year of mepolizumab treatment were calculated for patients in the Australian Mepolizumab Registry. In cost comparison analysis 1 (n=223), remission at 12-months was assessed with prospective evaluation of costs over the subsequent 12 months. Analysis 2 (n=222) evaluated remission at 24-months with retrospective evaluation of costs over the prior 12 months. Clinical remission was defined as: zero exacerbations requiring hospitalisation, an emergency department (ED) visit or oral corticosteroid (OCS) use and zero OCS use during the previous six months; and Asthma Control Questionnaire (ACQ) -5 ≤1. Results Clinical remission was achieved in 28% (Analysis 1) and 33% (Analysis 2) of patients receiving mepolizumab. Analysis 1 (prospective): annual mean costs during the second year of mepolizumab treatment were 45% lower in patients who had achieved remission. Per patient costs mean (95% CI) for remission were 1318. 19 (972. 45, 1663. 93) versus non-remission 2405. 63 (1712. 56, 3098. 70). Analysis 2: mean costs were 52% lower in the remission group mean (95% CI) costs for remission 1231. 22 (996. 29, 1466. 15) versus non-remission 2540. 88 (1773. 44, 3308. 33). Across analyses, costs associated with hospitalisations and ED visits for exacerbations, asthma-related outpatient visits and medication use were lower in patients who achieved remission. Conclusion Achieving clinical remission with mepolizumab in SEA is associated with additional cost savings from the health care payer's perspective, further highlighting the importance of timeliness and appropriateness of biologic treatments in severe asthma.
Harvey et al. (Thu,) studied this question.