Benralizumab: Cost-Effective Add-On Therapy for Refractory Eosinophilic Asthma

Eosinophil cells
Eosinophil cells
In patients with refractory eosinophilic asthma, treatment with benralizumab is a cost-effective option to be used as add-on therapy.

In patients with refractory eosinophilic asthma, treatment with benralizumab is a cost-effective option to be used as add-on therapy. A cross-sectional, multicenter study was conducted among consecutive patients with severe asthma in Spain. Results of the analysis were published in the journal Respiratory Research.

Researchers sought to evaluate the clinical outcomes and health care expenditures following the incorporation of benralizumab into the standard treatment protocol for refractory eosinophilic asthma. A total of 44 patients were enrolled in the study and received treatment with benralizumab for at least 12 months. At least 3 clinic visits in specialized severe asthma units took place after treatment initiation with benralizumab: at 3 months of treatment, at 6 months of treatment, and a final visit at 12 months of treatment.

The main effectiveness parameters that were analyzed included: (1) avoidance of 1 asthma exacerbation; (2) a 3-point increase in the asthma control test (ACT) score; and (3) the difference in utility scores (ie, health-related quality of life) between baseline treatment and benralizumab treatment. Additional parameters of effectiveness included decrease in severe exacerbations of asthma and emergency department (ED) visits, reduction in the use of oral corticosteroids (OCS) and inhaled corticosteroids (ICS), and improvement in lung function and asthma control based on ACT scores. Direct costs and incremental cost-effectiveness ratios (ICERs) comprised the health economic assessment.

After 1 year of benralizumab treatment, an 83% reduction in ED visits, an 88% decrease in severe exacerbations, a 79.8% reduction in the prednisone (or equivalent) dose, a 55.6% decrease in the number of corticosteroid-dependent patients, and an 82.3% decrease in the number of OCS courses were reported. Overall, 65.9% of patients required zero ED visits during the 1-year benralizumab treatment course, and 47.7% did not take any OCS.

The annual total cost per patient for the baseline and benralizumab treatment periods were €11,544 and €14,043, respectively. This represents an increase in costs because of the price of the biologic agent but a decrease in cost for the remaining parameters. The ICER was €602 per avoided a severe asthma exacerbation and €983.86 for each 3-point increase in ACT score.

The study authors concluded that 1-year treatment with benralizumab in patients with severe asthma is associated with a clear improvement in lung function and asthma control, as well as a decrease in severe asthma exacerbations, ED visits, and the use of OCS and ICS. This biologic agent appears to be a cost-effective option (<€24,000 per quality-adjusted life-years) as add-on therapy in this patient population.

Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Padilla-Galo A, García-Ruiz AJ, Levy Abitbol RC, et al. Real-life cost-effectiveness of benralizumab in patients with severe asthma. Respir Res. 2021;22(1):163. doi:10.1186/s12931-021-01758-0