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. 2023 Mar 7;24(1):70.
doi: 10.1186/s12931-023-02372-y.

Effectiveness and economic impact of Dupilumab in asthma: a population-based cohort study

Paola Faverio #  1   2 , Raffaella Ronco #  3   4 , Matteo Monzio Compagnoni  3   4 , Matteo Franchi  3   4 , Giovanni Franco  5 , Giulia Bonaiti  5 , Martina Bonifazi  6 , Federico Mei  6 , Fabrizio Luppi  5 , Alberto Pesci  5 , Giovanni Corrao  3   4
Affiliations

Effectiveness and economic impact of Dupilumab in asthma: a population-based cohort study

Paola Faverio et al. Respir Res. .

Abstract

Rationale: Severe asthma is burdened by relevant socio-economic and clinical impact. Randomized controlled trials on Dupilumab showed efficacy and a good safety profile, but post-market studies are needed.

Objectives: To evaluate the impact of Dupilumab on (i) the use of anti-asthmatic drugs, including oral corticosteroids (OCS), (ii) the rates of asthma exacerbation-related hospital admissions, and (iii) the healthcare costs in patients with asthma.

Methods: Data were retrieved from Healthcare Utilization database of Lombardy region (Italy). We compared healthcare resources use between the 6 months after Dupilumab initiation ("post-intervention period") and (i) the 6 months before Dupilumab initiation ("wash-out period") and (ii) the corresponding 6 months of the prior year ("pre-intervention period").

Main results: In a cohort of 176 patients, Dupilumab significantly reduced anti-asthmatic drugs use (including OCS and short-acting β2-agonists, inhaled corticosteroids (ICS)/long-acting β2-agonists and ICS alone) when comparing the "pre-intervention" to the "post-intervention" period. When considering hospital admissions, we observed a not statistically or marginally significant reduction between both periods before Dupilumab and the post-intervention period. Six-months discontinuation rate was 8%. Overall healthcare costs had a tenfold increase between the "pre-intervention" and "post-intervention" period, which was mainly led by the biologic drug cost. Conversely, expenditures connected to hospital admissions did not change.

Conclusions: Our real-world investigation suggests that Dupilumab reduced anti-asthmatic drugs use, including OCS, in comparison to a corresponding period in the prior year. However, long-term healthcare sustainability remains an open issue.

Keywords: Asthma; Clinical allergy and immunology; Inflammation.

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Conflict of interest statement

GC received research support from the European Community (EC), the Italian Medicines Agency (AIFA), and the Italian Ministry of Education, Universities and Research (MIUR). He took part in a variety of projects that were funded by pharmaceutical companies (Novartis, GSK, Roche, AMGEN and BMS). He also received honoraria as a member of the Advisory Board of Roche. No other potential conflicts of interest were declared for the other authors.

Figures

Fig. 1
Fig. 1
Flow-chart of inclusion and exclusion criteria for the eligibility of patients with a diagnosis of asthma and receiving at least one prescription of Dupilumab during the period December, 1st 2020 and July, 31st 2021. ¥Patients (i) with an active exemption, or (ii) who experienced a previous hospital admission with diagnosis for asthma or asthma-related respiratory problems
Fig. 2
Fig. 2
Study design. Index date: date of the first prescription of Dupilumab
See this image and copyright information in PMC

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