Cailin Conner

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A recent study published in JAMA Dermatology examined the cost and cost-effectiveness of chronic urticaria (CU) management strategies, focusing on biologic therapies such as omalizumab, routine laboratory testing, and other standard treatments.
Researchers conducted a systematic literature search across six major databases, including MEDLINE, Embase, PubMed, Cochrane, Scopus, and CINAHL. The inclusion criteria were specific to studies that performed cost analysis or full economic evaluations among patients with CU. Two independent reviewers extracted relevant data, such as annual health care costs and incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY). All monetary values were standardized and adjusted to 2023 US dollars to ensure consistency across studies.
The study included 17 unique studies; 11 focused on cost analysis, and six performed full economic evaluations.
Following the analysis, researchers noted that using biologic omalizumab was associated with higher annual health care costs than other management strategies that did not include this biologic agent.
Specifically, the studies found that the median annual cost for CU management involving omalizumab was $6,933, with an interquartile range (IQR) of $5,988 to $8,717. Alternatively, CU management strategies that did not include omalizumab had a median cost of $5,621 (IQR, $2,488-8,754).
Despite the higher costs, omalizumab was found to be cost-effective within the US health care system for H1 antihistamine-refractory chronic spontaneous urticaria (CSU), with a median ICER of $89,005 per QALY (IQR, $36,058-145,694). This ICER was within the commonly accepted willingness-to-pay threshold of $150,000 per QALY.
Routine laboratory testing in patients with CSU who had otherwise normal histories and physical examination findings was not cost-effective. The ICERs for these tests ranged from $1,427,928 to $1,950,524 per QALY, which exceeded the willingness-to-pay threshold.
“Price negotiations and rebates of high-cost drugs may help promote sustainability and more effective health care allocation for CU,” the investigators wrote regarding the implications of their review.
Source: <a href="https://jamanetwork.com/journals/jamadermatology/article-abstract/2823063" target="_blank" rel="noopener">JAMA Dermatology</a>

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