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. 2022 Jun 10;12(6):951.
doi: 10.3390/jpm12060951.

Cost-Utility Analysis of Dupilumab for the Treatment of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) in Italy

Eugenio De Corso  1 , Gianluca Furneri  2 , Daria Salsi  3 , Francesca Fanelli  4 , Gianluca Ronci  4 , Giovanna Sala  4 , Rossella Bitonti  2 , Domenico Cuda  5
Affiliations

Cost-Utility Analysis of Dupilumab for the Treatment of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) in Italy

Eugenio De Corso et al. J Pers Med. .

Abstract

The objective of this analysis was to estimate the incremental cost-utility ratio (ICUR) of dupilumab as an add-on treatment to best supportive care (BSC), versus BSC alone, in Italy for severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP). A simulation of outcomes and costs was undertaken using a 1-year decision tree, followed by a lifetime horizon Markov model. Clinical data were derived from a pooled analysis of two studies (SINUS-24 NCT02912468 and SINUS-52 NCT02898454). The Italian National Healthcare Service (NHS) perspective was considered. Model robustness was tested through sensitivity analyses. In the base-case analysis, treatment with dupilumab + BSC resulted in an increase in quality of life-adjusted survival (+1.02 quality-adjusted life years (QALY-gained)), compared to the BSC alone. The resulted ICUR was €21,817 per QALY-gained and it is below the acceptability threshold commonly used in Italy. Both one-way deterministic and probabilistic sensitivity analyses confirmed the robustness of base-case results. The cost-utility analysis showed that dupilumab, as an add-on treatment to BSC, is a cost-effective therapeutic alternative to BSC in the treatment of patients with severe uncontrolled chronic rhinosinusitis with nasal polyps, confirming that it is economically sustainable.

Keywords: CRSwNP; cost–utility analysis; dupilumab.

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Conflict of interest statement

F.F., G.S. and G.R. are employed by Sanofi and may hold shares and/or stock options in the company. G.F. and R.B. received consulting fees from Sanofi for analysis conduction. E.D.C., D.S. and D.C. received fees from Sanofi for the participation in Advisory Boards and/or Conferences.

Figures

Figure 1
Figure 1
Model structure: (a) Decision tree; (b) Markov model. Note: BSC, best supportive care; CRSwNP, chronic rhinosinusitis with nasal polyps; DUP, dupilumab.
Figure 2
Figure 2
Response rate at 24 and 52 weeks.
Figure 3
Figure 3
Tornado graph (deterministic sensitivity analysis): dupilumab + BSC vs. BSC (base-case). Note: BSC, best supportive care; DUP, dupilumab; ICUR, incremental cost–utility ratio; QALY, quality adjusted life year.
Figure 4
Figure 4
Cost–utility acceptability curve: dupilumab + BSC vs. BSC (base-case; N = 1000 simulations; ICUR in base-case: €21,817/QALY-gained).
Figure 5
Figure 5
Results of the probabilistic sensitivity analysis.
See this image and copyright information in PMC

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