ICER to Review Five Biologic Drugs Used for Severe Asthma

The Institute for Clinical and Economic Review (ICER) is going to review the class of biologic drugs used to treat moderate to severe eosinophilic asthma and release a report in November, the organization said. ICER performs analyses on the effectiveness and costs of medical tests, treatments, and delivery systems; develops reports assessing the value of key new drugs; and creates initiatives that use evidence to drive changes to both practice and policy.

The asthma drugs are:

• Dupilumab (Dupixent, Sanofi/Regeneron)
• Omalizumab (Xolair, Genentech/Novartis),
• Mepolizumab (Nucala, GlaxoSmithKline)
• Reslizumab (Cinqair, Teva)
• Benralizumab (Fasenra, AstraZeneca)

ICER previously reviewed mepolizumab for its use in severe eosinophilic asthma and dupilumab for its use in atopic dermatitis.

In its previous report on mepolizumab, ICER said the therapy should be priced far below its list price of $32,500 a year, suggesting that it would be cost effective if priced at no more than $7800 to about $12,000 a year.

Dupilumab is currently under FDA review for use as add-on maintenance treatment in moderate-to-severe asthma, with an approval decision expected in this October. It has “breakthrough” designation for its use in severe atopic dermatitis (AD) and is intended for patients whose condition has not improved with use of topical treatments, or who are not advised to take these treatments. Dupilumab works on 2 interleukins that are believed to trigger AD by binding to their cell receptors to calm the inflammatory response and reduce the symptoms.

Last year, ICER recommended that dupilumab represented a good value as it improved health outcomes even thought there were some additional costs.

Asthma costs the US economy more than $80 billion annually in medical expenses, days missed from work and school, and deaths, according to research published earlier this year in the Annals of the American Thoracic Society.

An estimated 22 million Americans have asthma, and the problem is going to get worse, with about 100 million people affected by 2025.