The costs of asthma biologic medications can be quite expensive. Currently on the market there are 5 available.
- Xolair (omalizumab)
- Nucala (mepolizumab)
- Cinqair (reslizumab)
- Fasenra (benralizumab)
- Dupixent (Dupilumab)
We have discussed each of them extensively in previous post.
Xolair (Omalizumab) for Chronic Urticaria (this post discusses Xolair’s approval for chronic urticaria (hives) it was approved for moderate to severe persistent asthma in 2003. Xolair Approved For Asthma from WebMD
Uncontrolled asthma is a significant problem worldwide. Many patients can use controller medication that have been around for decades. A major problem though is nonadherence to regular use of inhaled corticosteroids and long acting beta agonists. Once medication adherence has been undergone and patients still have continued asthma exacerbations, one of the asthma biologic medications can be considered. The costs of asthma biologics are an important factor to consider for patients. The wholesale acquisition cost of 1 year of treatment excluding administration costs are below:
- Xolair $39,048 (Xolair’s dose can vary widely depending on the patients weight and IgE level, the higher the dose and weight, more Xolair would be needed, necessitating higher costs). XOLAIR Dosing Tool for Allergic Asthma
- Nucala $37,293 (Nucala dosing is 100mg every 4 weeks)
- Cinqair $31,637 (Cinqair is dosed by weight, 3mg/kg every 4 weeks by an IV infusion, so the dose can vary widely depending on the weight).
- Fasenra $30,889 (Fasenra is given 1 time a month for the first 3 months at 30mg, then every 8 weeks after, although the maintenance dose is given every other month, the cost is relatively the same as the other biologics).
- Dupixent $38,110 (Dupixent has a loading dose of 600mg then it is given at 300mg every 2 weeks, the injections can be self-administered at home).
As you can see, the costs of asthma biologic medications are extremely high. There has been studies debating the cost effectiveness of these medications, and there will be further studies about it. A recent study published in The Annals of Allergy, Asthma and Immunology concluded the costs of biologic medications need to be reduced by approximately 60% to meet cost-effectiveness. Another factor is the duration of treatment, as of now manufacturers recommend continued treatment of the medications.
In terms of effectiveness, all currently approved biologics have relatively comparable efficacy when compared to placebo. Head to head studies are currently lacking. In another blog post we did explore some head to head data.