Comparison of Costs and Clinical Outcomes Between Hospital and Outpatient Administration of Omalizumab in Patients With Severe Uncontrolled Asthma

Objectives: To compare clinical outcomes and costs between two administration strategies of omalizumab treatment. Method: We evaluated two cohorts of patients with uncontrolled severe asthma over a 1-year period. Patients received the treatment in the primary care center in Hospital A and conventional hospital administration in Hospital B. Results: We studied 130 patients, 86 in Hospital A and 44 in Hospital B, 30 men (24%) and 100 women (76%), age 50 +/- 15 years, FEV1% 67 +/- 22%, body mass index (BMI) 28 +/- 6 kg/m(2), 639 +/- 747 UI IgE/mL, followed for 24 +/- 11 months (12-45), Asthma Control Test (ACT) score 12 +/- 4 and Asthma Control Questionnaire (ACQ) 3 +/- 2. There were no significant pretreatment differences between the groups in hospital admissions and emergency room visits in the previous year, nor in proportion of patients receiving oral steroids. Evaluations were performed at baseline and after 12 months of treatment, revealing significant differences in ACT (P < 0.001), ACQ(P < 0.001), improvement in FEV1% (P< 0.001), reduction in total admissions (P< 0.001), days of hospitalization (P< 0.001), emergency room visits (P<0.001), cycles and doses of oral steroids (P< 0.001) compared to the previous year. Hospitalization costs, emergency room visits, unscheduled visits to primary care and to the pulmonologist were significantly reduced in each hospital and on the whole, but administration and travel costs were 35% lower in the ambulatory strategy adopted in Hospital A. Conclusion: The administration of omalizumab in ambulatory health centers achieved the same clinical results as a hospital administration strategy, but with lower costs. (C) 2015 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.