Сost of the Biologacal Therapy for Severe Brochcial Asthma Treatment at Inpatient and Day Care Setting

Abstract

Objective: to assess the cost of the severe bronchial asthma (BA) treatment with various biological agents at inpatient and day care setting from the compulsory medical insurance (CMI) system perspective. Methods. The authors constructed the MS Excel® analytical decision-making model and calculated the CMI system’s costs of severe BA treatment with various biological drugs at inpatient and day care setting. The costs of treatment with benralizumab, dupilumab, omalizumab, reslizumab and mepolizumab were compared. The cost difference between benralizumab and other drugs was identified taking into account the frequency of the drugs’ administration. The first administration was assumed to be inpatient, followed by the administrations in day care ward. Results. The use of benralizumab reduces the expenses of the CMI system by 0.8 million rubles per patient (–39%) compared with omalizumab, mepolizumab, resizumab and by 2.9 million rubles per patient (–69%) versus dupilumab due to the lowest frequency of administration, therefore less hospitalizations for therapy. With a 5-year modeling horizon, benralizumab therapy allows to reduce the CMI system expenses by 4.5 million rubles (–48%) compared with omalizumab, mepolizumab, reslizumab and by 13.9 million rubles (–74%) compared with dupilumab. The use of benralizumab will release 5–7 cases per patient per year compared to omalizumab, resizumab and mepolizumab and 18–20 cases per patient per year compared to dupilumab. Conclusion. Benralizumab therapy in patients with severe BA in inpatient and day care settings will lead to the optimization of CMI expenditures and more rational use of budgets allocated to hospitals.