Dupilumab Among Patients with Uncontrolled Severe Asthma in China: A Cost-Utility Analysis
Year: 2025
Type: article
Abstract: Zheng Liu,1 Maosheng Xu,2 Huifang Zhu,1 Jinzhen Huang,1 Xuhui Ye,1 Xintian Shen,1 Xiaomei Fan1 1Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, 518102, People’s Republic of China; 2Department of Respiratory, Guangzhou Panyu District Maternal and Child Health Hospital, Guangzhou, 511400, People’s Republic of ChinaCorrespondence: Xiaomei Fan, Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, 518102, People’s Republic of China, Email [email protected]: Dupilumab’s recent approval in China as an add-on therapy for asthma provides a novel therapeutic alternative for severe asthma management, but its economic benefits remain unsubstantiated in China. This study aimed to adopt a cost-utility analysis to evaluate the economics of dupilumab in the treatment of uncontrolled severe asthma and provide an evidence-based reference for clinical decision-making and therapeutic regimen selection.Methods: From the healthcare perspective, a Markov model was developed to simulate costs and quality-adjusted life years (QALYs) over a five-year time horizon for uncontrolled severe asthma patients aged ≥ 12 years receiving either dupilumab add-on therapy or standard-of-care (SoC) therapy alone. The incremental cost-utility ratio (ICUR) served as the primary outcome and was compared with the willingness-to-pay (WTP) threshold based on per capita gross domestic product (GDP) of China ($13,444.68/QALY) to determine the economics of therapeutic alternatives. The robustness of the results was verified using sensitivity analysis, and the impact of the dupilumab price on outcomes was evaluated using scenario analysis.Results: Compared with SoC therapy, dupilumab add-on therapy incurred higher costs but provided greater utility gains, with an ICUR of $83,941.87 per QALY gained, which exceeded the WTP threshold. One-way sensitivity analysis identified the utility of controlled asthma as the predominant influential factor, followed by the price of dupilumab. Probabilistic sensitivity analysis showed that 98.8% of simulations were consistent with the base-case results, and SoC therapy had a higher probability of cost-utility acceptability than dupilumab add-on therapy. Scenario analysis revealed that reducing dupilumab’s price to $70.38 would render its ICUR below the WTP threshold.Conclusion: Based on the current Chinese healthcare system, it was not cost-utility to apply dupilumab as an add-on therapy for patients aged ≥ 12 years with uncontrolled severe asthma. A substantial price reduction of dupilumab could improve affordability in this patient population.Keywords: dupilumab, biologics, severe asthma, pharmacoeconomics, cost-utility analysis
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7084771438
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