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Cost utility analysis of dupilumab vs endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps

The Laryngoscope Apr 09, 2020

Scangas GA, Wu AW, Ting JY, et al. - In the present study, the researchers sought to assess cost‐effectiveness of dupilumab compared with endoscopic sinus surgery (ESS) for patients with chronic rhinosinusitis with nasal polyps (CRSwNP). A cohort of 197 CRSwNP individuals who had ESS were contrasted with a matched cohort of 293 CRSwNP patients from the SINUS‐24 and SINUS‐52 Phase 3 studies who had treatment with dupilumab 300 mg every 2 weeks. According to results, the ESS strategy cost $50,436.99 and produced 9.80 QALYs and the dupilumab treatment strategy cost $536,420.22 and produced 8.95 QALYs. Due to the fact that dupilumab treatment was more costly and less effective than the ESS strategy, the ESS predominates in the base case. One‐way sensitivity analyses demonstrated that ESS was cost‐effective compared with dupilumab irrespective of the frequency of revision surgery and at any annual cost of dupilumab above $855. For upfront treatment of CRSwNP, the ESS treatment strategy is more cost effective than dupilumab. Further studies are required to isolate potential phenotypes or endotypes that will benefit most from dupilumab in a cost‐effective manner.

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