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Is Xolair cost-effective in severe asthma?

Omalizumab (Xolair) is a monoclonal antibody made by Genentech/Novartis. In more detail, it is a recombinant DNA-derived humanized IgG1k monoclonal antibody that selectively binds to human immunoglobulin E (IgE). Omalizumab binds to Cε3 region of IgE.

Omalizumab is approved by the FDA for treatment of moderate-to-severe allergic asthma. According to this study, Xolair may be cost-effective in adults with severe asthma only if the price is less than $200 per dose.

Authors conclude that omalizumab is not cost-effective for most patients with severe asthma and based on its high cost, clinicians should explore alternative medications for asthma before initiating omalizumab.

However, a 2010 study showed that oral corticosteroids were withdrawn in 74% of severe asthma patients treated with omalizumab - Current Medical Research and Opinion, 2010.

Severe asthma - differential diagnosis and management (click to enlarge the image).

Reference:
Cost-effectiveness of omalizumab in adults with severe asthma: Results from the Asthma Policy Model. J Allergy Clin Immunol. 2007 Sep 27.
Omalizumab from Wikipedia, the free encyclopedia.

Response to omalizumab after 16 weeks is a predictor of continuing persistent response to omalizumab in asthmatics. Allergy 2011.
Images: Mechanisms of action of omalizumab. JACI, 02/2008.
Image source: Wikipedia, public domain.