NICE recommends omalizumab as an option for treating severe persistent confirmed allergic IgE mediated asthma as an add on to optimised standard therapy in people aged 6 years and older:
• who need continuous or frequent treatment with oral corticosteroids (defined as 4 or more courses in the previous year), and
• only if the manufacturer makes omalizumab available with the discount agreed in the patient access scheme.
Optimised standard therapy is defined as a full trial of and, if tolerated, documented compliance with inhaled high dose corticosteroids, long acting beta2 agonists, leukotriene receptor antagonists, theophyllines, oral corticosteroids, and smoking cessation if clinically appropriate.
The Appraisal Committee concluded, based on a number of assumptions, that the most plausible ICER was £23,200 per QALY gained for the combined population of adults, adolescents and children on maintenance or frequent courses of oral corticosteroids. The Committee was persuaded that the uncaptured benefits of reducing dependence on oral corticosteroids were sufficient to justify accepting this ICER.