Background: There has been a growth in the number of economic evaluations in the literature, reporting important differences in their designs and results for a particular health technology. Previous research has shown systematic differences among incremental cost-effectiveness ratios (ICERs) and Cost-Effectiveness Analysis (CEA) conclusions in industry-sponsored evaluations. Since ICERs are used for reimbursement decisions, exploring these differences may improve healthcare decision-making. Biological treatments for asthma have been extensively evaluated, and vast differences in the cost-effectiveness of the same drug have been reported. Therefore, studying these differences could serve as a base-case scenario to better understand differences in CEA.
Objectives: To describe the methodological characteristics of the CEA of treatment with biologics for severe asthma and assess their methodological limitations. Furthermore, we will evaluate the association between methodological characteristics and ICERs in these studies.
Methods: We will include CEA of omalizumab, mepolizumab, reslizumab, dupilumab, benralizumab, and tezepelumab, compared with the standard of care in adults diagnosed with severe asthma, that report ICERs as the primary outcome. We developed a search strategy for Medline and Embase. We will assess included studies with the consensus on the health economics criteria checklist (CHEC) for trial-based studies and ISPOR/ISMD checklist for studies using models. We will use regression analysis to examine the association between study characteristics (e.g., methodological quality) with the ICER and the cost-effectiveness conclusion (cost-effective or not). Expected results: After removing duplicates, we screened the title and abstract of 1364 records, including 26 studies after full-text evaluation. Our results will inform which study characteristics are associated with the incremental cost-effectiveness ratios. This information may be particularly useful for decision-makers, including funding agencies and guideline developers, raising awareness of the importance of carefully considering evidence from CEA.