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Currently, limited information is available to clinicians regarding the long-term efficacy of omalizumab treatment for allergic asthma.In this report, we aimed to (i) systematically review the evidence regarding the long-term efficacy of omalizumab as an add-on therapy in patients with persistent uncontrolled allergic asthma, and to (ii) discuss the cost-effectiveness evidence published for omalizumab in this patient population.A comprehensive search for randomized controlled trials (RCTs; ≥52 weeks) was performed, and six studies met our final inclusion criteria (n=2,749).Omalizumab was associated with a significant decrease in the risk of asthma exacerbation compared with conventional therapy, and with significant improvements in quality of life.Omalizumab also allowed patients to completely withdraw from inhaled corticosteroid therapy, and it achieved better results in the Global Evaluation of Treatment Effectiveness than did the standard therapies.Omalizumab did not increase the overall incidence of adverse events.