OBJECTIVES: To estimate and compare the cost per Psoriasis Area and Severity Index (PASI) ≥90 responder of secukinumab, the first and only fully human IL17-A antibody, as first biologic treatment, relative to adalimumab, ustekinumab, infliximab, and etanercept in moderate to severe psoriasis patients, at 16 and 52 weeks and cost per sustained response from 16 to 52 weeks, from the Argentina perspective.
METHODS: A 52-week decision-tree model was developed. Response to treatment was assessed based on the likelihood of achieving a predefined PASI response to separate the cohort into responders (PASI ≥75), partial responders (PASI 50 to 74), and non-responders (PASI <50). Responders at week 16 continued initial treatment, whereas partial responders and non-responders were switched to standard of care, which included methotrexate, cyclosporine, phototherapy, and topical corticosteroids. Sustained response was defined as 16-week response maintained at week 52. Clinical efficacy data was obtained from a mixed-treatment comparison. Drug costs were estimated using local public price (June 2018) and the number of doses required for 52 weeks. Sensitivity analysis was performed to evaluate the impact of including 20% discount on the comparator prices.
RESULTS: Secukinumab had the lowest cost per PASI 90 responder over 16 weeks (ARS 539,882) compared with ustekinumab (ARS 627,035), adalimumab (ARS 735,700), etanercept (ARS1,011,579) and infliximab (ARS 1,392,728). Over 52 weeks, costs per PASI 90 responder ranged from ARS1,254,865 (secukinumab) to ARS 2,743,392 (infliximab). Likewise, secukinumab had the lowest cost per sustained 52-week PASI 90 responder (ARS 682,852) compared with other biologic treatments. Sensitivity analysis showed similar results.
CONCLUSIONS: First biologic treatment with secukinumab for moderate to severe psoriasis was cost-effective, with lowest cost per responder compared with other biologic treatments in Argentina.
