OBJECTIVES: Tezepelumab is a human monoclonal antibody specific for the epithelial-cell–derived cytokine thymic stromal lymphopoietin (TSLP). A Phase III trial demonstrate that tezepelumab treatment resulted in fewer exacerbations, improved lung function and asthma control, and increased health-related quality of life. This study aimed to evaluate the long-term cost-effectiveness of tezepelumab for treating severe asthma in Taiwan to strengthen its value.

METHODS: A Markov model was used to evaluate the cost-effectiveness of tezepelumab compared to benralizumab, mepolizumab, and omalizumab for treating severe asthma patients. The model parameters were derived from the NAVIGATOR and SOURCE clinical trials and costs were sourced from the literature and NHIA (National Health Insurance Administration) drug costs from Taiwan. This study adopted the perspective of Taiwan NHIA. Quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were evaluated.

RESULTS: Compared to Benralizumab, Tezpelumab increases QALYs at lower treatment costs, showing absolute dominant and cost-effectiveness (ICER: TWD $-2,212,337.24/QALY). Similarly, compared to Mepolizumab, Tezpelumab results in increased QALYs with lower treatment costs, demonstrating absolute dominant and cost-effectiveness (ICER: TWD $-6,742,473.66/QALY). In comparison to Omalizumab, Tezpelumab increases QALYs with slightly higher treatment costs (ICER: TWD $619,236.13/QALY), below both WTP (3 times the per capita GDP (TWD $2,925,582) and per capita GDP (TWD $975,194) thresholds in Taiwan indicating cost-effectiveness. Probabilistic sensitivity analysis shows Tezpelumab's high probability of cost-effectiveness compared to Benralizumab, Mepolizumab, and Omalizumab.

CONCLUSIONS: The model reflects the rates of exacerbations and its subsequent treatment requirements. Patients who experience an exacerbations result in either a burst in OCS, an A&E visit or hospitalization, the latter resulting in the largest cost and quality of life burden. The results from the analysis show that tezepelumab is dominant and is a cost-effective treatment when compared to the other biologics.