INTRODUCTION
Asthma is one of the most common chronic diseases in children;(1) prevalence in Europe ranges from 2.2% to 11.9%.(2) Asthma in children accounts for approximately half of asthma-related hospitalizations in Canada, (3) and so it is accountable for huge costs, which are comprehensively very difficult to estimate as they include:
In the US, the total direct costs of pediatric asthma in 2013 accounted for $5.9 billion, mainly due to hospitalizations and emergency department visits.(6) In this context, severe asthma accounts for the majority of asthma costs. Most of the proposed definitions for severity include poor symptom control and use of high doses of medication, and many also include frequent exacerbations.(7) Despite its low prevalence (up to 5% of cases), severe forms account for a considerable proportion of the disease-related costs.(7,8) Poor symptom control, in addition, is associated with lower QoL of asthmatic children and their caregivers.(9,10)
Children aged ≥ 6 years with severe persistent allergic asthma (SPAA) not controlled with high-dose inhaled corticosteroids (ICS) plus long-acting beta‑agonists (LABA) have the option to receive targeted therapy with omalizumab (OMZ).(1) This monoclonal antibody prevents IgE from binding to the FcɛRI receptors, avoids the activation and triggering of the allergic cascade, and downregulates the production of IgE.(11) Clinical trials (12–14) and real life studies (15–18) have demonstrated the safety, efficacy and effectiveness of OMZ in pediatric patients, showing a reduction of symptoms, exacerbations, use of rescue medication, medical visits and hospitalizations, and an improvement in QoL.
Although there are some studies analyzing the costs in pediatric asthma,(2,5,8,19,20) the majority of pharmacoeconomic studies involve general population. The specific evaluation in severe pediatric asthma is needed as the use of biologic treatments in children has significantly increased the direct medical costs.
The aim of our study was to evaluate the evolution of direct medical costs related to healthcare resources and medication in a large cohort of children with SPAA treated with OMZ, followed up to 6 years since the beginning of the treatment.