1
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Daudén E, Escario E, Martos-Cabrera L, Armesto S, Herrera-Acosta E, Vidal D, Vilarrasa E, Rivera R, de la Cueva P, Martorell A, Ballesca F, Belinchón I, Carretero G, Rodríguez L, Romero-Maté A, Pujol-Montcusí J, Salgado L, Sahuquillo-Torralba A, Coto-Segura P, Baniandrés O, Feltes R, Riera-Monroig J, Garrido J, Llamas-Velasco M. Dose reduction is a feasible strategy in patients with plaque psoriasis who achieve sustained response with secukinumab: a retrospective, multicenter cohort study in daily practice setting. Int J Dermatol 2024; 63:503-511. [PMID: 38168847 DOI: 10.1111/ijd.16915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 10/16/2023] [Accepted: 11/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Biological therapy dose modification is a common practice in the long-term treatment of plaque psoriasis. OBJECTIVE The objective of the study was to determine prevalence, characteristics of patients, effectiveness, treatment survival of secukinumab dose reduction (SEC-DR) strategy and assess its safety and cost implications. METHODS A retrospective, observational, multicenter cohort study was conducted in patients with plaque psoriasis treated with secukinumab and up to 2 years of follow-up. RESULTS In 63/347 patients with an initial standard dose regimen, SEC-DR was tried at any moment in 18.2% of them after sustained response. In 51 patients, the interval between administrations was increased while in 12 patients, monthly dose was reduced to 150 mg. Successful SEC-DR was achieved in 77.8% of the patients, with sustained PASI response to the end of the study. Survival of secukinumab treatment and safety profile were not compromised by DR. The use of DR saved 33% of the cost, including failures in which standard treatment was resumed. LIMITATIONS The proper of the study designed and the arbitrary definition of "DR success." CONCLUSION Off-label SEC-DR strategy was used in patients with sustained response to standard dose regimen; this strategy showed long-term efficacy without compromising treatment survival or worsening the safety profile while also being cost saving.
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Affiliation(s)
- Esteban Daudén
- Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Elena Escario
- Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Luisa Martos-Cabrera
- Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Susana Armesto
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - David Vidal
- Hospital de Sant Joan Despí Moisés Broggi, Barcelona, Spain
| | - Eva Vilarrasa
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | - Ferran Ballesca
- Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - Isabel Belinchón
- Hospital General Universitario de Alicante - ISABIAL, Alicante, Spain
| | | | | | | | - J Pujol-Montcusí
- Hospital Universitario de Tarragona "Joan XXIII", Tarragona, Spain
| | - Laura Salgado
- Complejo Hospitalario Universitario, Pontevedra, Spain
| | | | | | | | - R Feltes
- Hospital Universitario la Paz, Madrid, Spain
| | | | | | - Mar Llamas-Velasco
- Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
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2
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Gisondi P, Geat D, Maurelli M, Degli Esposti L, Bellinato F, Girolomoni G. Cost per Responder Analysis of Secukinumab versus Adalimumab in the Treatment of Psoriatic Disease. Vaccines (Basel) 2022; 10:646. [PMID: 35632402 PMCID: PMC9142895 DOI: 10.3390/vaccines10050646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/13/2022] [Accepted: 04/16/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The EXCEED study evaluated the efficacy and safety of secukinumab versus adalimumab in psoriatic arthritis, but it did not include a pharmacoeconomic analysis. The objective of this study was to compare the cost per responder of secukinumab versus adalimumab in patients with psoriatic disease. METHODS The cost per responder was calculated by multiplying the cost of treatment by the number needed to treat for each therapy. The 52-week primary endpoint was the American College of Rheumatology response rate (ACR) 20; secondary endpoints were ACR 50, Psoriasis Area and Severity Index (PASI) 90, and minimal disease activity (MDA). RESULTS The cost per responder for ACR 20 was €19,846 versus €19,766 for secukinumab and adalimumab, respectively, whereas the costs per responder for ACR 50 and PASI 90 were €27,820 versus €27,384 and €22,102 versus €32,375 for secukinumab and adalimumab, respectively. The cost per MDA responder was €34,072 and €38,906 for secukinumab versus adalimumab. CONCLUSIONS The costs per responder associated with the psoriatic arthritis end points were similar for adalimumab and secukinumab; conversely, the costs for psoriasis and composite end points were lower for secukinumab.
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Affiliation(s)
- Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; (D.G.); (M.M.); (F.B.); (G.G.)
| | - Davide Geat
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; (D.G.); (M.M.); (F.B.); (G.G.)
| | - Martina Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; (D.G.); (M.M.); (F.B.); (G.G.)
| | - Luca Degli Esposti
- CliCon S.r.l. Health, Economics & Outcomes Research, 40121 Bologna, Italy;
| | - Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; (D.G.); (M.M.); (F.B.); (G.G.)
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; (D.G.); (M.M.); (F.B.); (G.G.)
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3
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de Oliveira MDFP, Rocha BDO, Duarte GV. PASI 100 response to secukinumab in primary failure to ustekinumab: analysis of cost-effectiveness among biological drugs. Int J Dermatol 2021; 60:1165-1167. [PMID: 33934333 DOI: 10.1111/ijd.15493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/10/2021] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Maria de Fátima P de Oliveira
- Department of Dermatology, University Hospital Complex Prof. Edgard Santos, The Federal University of Bahia (C-HUPES/UFBa), Salvador, Bahia, Brazil
| | - Bruno de O Rocha
- Department of Dermatology, University Hospital Complex Prof. Edgard Santos, The Federal University of Bahia (C-HUPES/UFBa), Salvador, Bahia, Brazil.,Aristides Maltêz Hospital, The Bahia's League Against Cancer (HAM-LBCC), Salvador, Bahia, Brazil.,The Holy Family Hospital, Sister Dulce Social Works (HSF-OSID), Salvador, Bahia, Brazil.,Integrated Center for Education and Health (CIES) -UniFTC, Salvador, Bahia, Brazil
| | - Gleison V Duarte
- Instituto Bahiano de Imunoterapia (IBIS), Salvador, Bahia, Brazil
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4
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Chen YC, Huang YT, Yang CC, Lai ECC, Liu CH, Hsu CK, Wong TW, Chao SC, Sheu HM, Lee CN. Real-world efficacy of biological agents in moderate-to-severe plaque psoriasis: An analysis of 75 patients in Taiwan. PLoS One 2020; 15:e0244620. [PMID: 33373425 PMCID: PMC7771674 DOI: 10.1371/journal.pone.0244620] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 12/12/2020] [Indexed: 01/12/2023] Open
Abstract
Background Real-world clinical data on psoriasis patients receiving different biological agents is needed, especially in Asian populations. Objectives Our aim is to compare and analyze the efficacy and safety profile of four biological agents (etanercept, adalimumab, ustekinumab and secukinumab) in a real-world setting in Taiwan. Methods We retrospectively analyzed the clinical data of all patients with moderate-to-severe plaque psoriasis (Psoriasis Area and Severity Index (PASI) ≥ 10) who received etanercept, adalimumab, ustekinumab or secukinumab between January 2011 and December 2018 in a tertiary hospital in Taiwan. Results A total of 119 treatment episodes in 75 patients were included in this study. Ustekinumab was used in 49 treatment episodes, followed by secukinumab in 46 treatment episodes, adalimumab in 14 treatment episodes and etanercept in 10 treatment episodes. The proportion of the biologic-naïve was highest in etanercept (100%) and lowest in secukinumab (23.9%). The PASI-75, -90 and -100 were the highest in secukinumab (91.3%, 82.6%, 41.3%, respectively), followed by ustekinumab (79.6%, 44.9%, 16.3%), adalimumab (64.3%, 28.6%, 7.1%) and etanercept (50.0%, 30.0%, 0%). The rate of adverse events that required treatment was highest for secukinumab (15.2%), followed by adalimumab (14.3%), ustekinumab (8.2%), and etanercept (0%), including 4 cases of infections, 2 cases of cardiovascular diseases and 4 cases of cancers. Conclusions This real world data showed differential efficacy and safety of the four biological agents.
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Affiliation(s)
- Yu-Chen Chen
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ting Huang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Chun Yang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Han Liu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan
| | - Tak-Wah Wong
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Center of Applied Nanomedicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheau-Chiou Chao
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hamm-Ming Sheu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chaw-Ning Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- * E-mail:
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Augustin M, Wirth D, Mahlich J, Pepper AN, Druchok C. Cost per responder analysis of guselkumab versus targeted therapies in the treatment of moderate to severe plaque psoriasis in Germany. J DERMATOL TREAT 2020; 33:976-982. [PMID: 32663067 DOI: 10.1080/09546634.2020.1793891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The fully human monoclonal antibody guselkumab is an effective treatment option for patients with moderate to severe psoriasis. OBJECTIVE The objective of this study was to examine the cost per responder of guselkumab compared with other targeted therapies for the treatment of moderate to severe plaque psoriasis in Germany. METHODS A one-year cost per responder model was developed based on efficacy and safety data from a published network meta-analysis. Drug, treatment administration, resource use, and adverse event costs were included in the analysis. The primary analysis assessed the cost per Psoriasis Area and Severity Index (PASI) 90 responder at week 16. Additional analyses were conducted at year 1. In the year 1 analyses, treatment response was assessed at the end of the induction period (week 16) to determine which patients continued onto maintenance therapy (responders) and which patients moved onto a subsequent adalimumab or secukinumab therapy (non-responders). RESULTS At week 16, the cost per PASI 90 responder was lower for guselkumab than all comparators except adalimumab and brodalumab. Similarly, in the year 1 analyses, guselkumab had a lower cost per PASI 90 responder than all comparators except brodalumab. CONCLUSIONS Guselkumab is a cost-effective therapy option in Germany.
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Affiliation(s)
- Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Jörg Mahlich
- Janssen-Cilag GmbH, Neuss, Germany.,Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany
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Puig L. Incremental Cost per Responder (PASI-75, PASI-90 and PASI-100) Based on a Network Meta-Analysis of Biologic Therapies for Psoriasis: Spain 2018. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:517-518. [PMID: 30791970 DOI: 10.1016/j.ad.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/01/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- L Puig
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
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7
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Puig L, Fernández-Freire LR, Burgos-Pol R, Gomez I, Peral C, Gomez S, Rebollo Laserna FJ. Economic Impact of Etanercept in Patients with Psoriasis and Psoriatic Arthritis in Spain: A Systematic Review. Dermatol Ther (Heidelb) 2019; 9:479-496. [PMID: 31062222 PMCID: PMC6704195 DOI: 10.1007/s13555-019-0301-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Etanercept (ETN), a highly effective biological agent for the treatment of psoriasis (PSO) and psoriatic arthritis (PsA), is widely used in Spain. However, evidence of its economic impact is limited, indicating the need for a systematic review of the economic assessments conducted on the use of ETN in the treatment of both PSO and PsA in Spain. METHODS A systematic review was carried out in PubMed, Embase, Cochrane Library, Health Technology Assessment reports and not indexed sources up to November 2018. The inclusion criteria were economic evaluations (total and partial) and dose optimization studies published in English or Spanish on the use of ETN to treat PSO and PsA for ETN in Spain. RESULTS A total of 402 publications were identified, of which 32 were selected for inclusion in the review; of these 32 publications, 81.3% analyzed PSO (14 full economic evaluations, 5 partial economic evaluations and 7 dose optimization studies) and 18.8% analyzed PsA (1 economic analysis and 5 dose optimization studies). The perspective of the Spanish National Health Service (NHS) was used in 90.0% (n = 18) of the full and partial economic evaluations. The time horizons ranged from 12 weeks to 2 years. Reductions in the Psoriasis Area and Severity Index (PASI) of 50, 75 and 90% (PASI 50, 75 and 90, respectively) were most commonly used as efficacy outcomes in the complete evaluations. The economic impact of ETN ranged from €9110-14,337/PASI 75 at 12 weeks (50 mg/week) to €82,279/PASI 90 at 2 years, depending on the health outcome, time horizon and ETN dose used. Only one study determined the cost of using ETN for the treatment of PSO (€29,430-52,367/QALY for dose 2 × 25 mg/week or 50 mg/week, respectively). Only one partial economic evaluation on PSA was identified (NHS perspective), resulting in an ETN annual cost of €8585/patient-year. CONCLUSION Consistent evidence on the economic impact of ETN for the treatment of PSO and PSA in Spain is lacking, mainly due to the highly heterogeneous methodology used and the broad range of outcomes found in the economic evaluations published to date. FUNDING Pfizer S.L.U.
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Affiliation(s)
- Lluís Puig
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Ramón Burgos-Pol
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain.
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A Cost-per-Number Needed to Treat Analysis Assessing the Efficiency of Biologic Drugs in Moderate to Severe Plaque Psoriasis. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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9
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Puig L. Incremental Cost per Responder (PASI-75, PASI-90 and PASI-100) Based on a Network Meta-Analysis of Biologic Therapies for Psoriasis: Spain 2018. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2018.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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10
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Núñez M, Huete T, de la Cueva P, Sacristán JA, Hartz S, Dilla T. A Cost-per-Number Needed to Treat Analysis Assessing the Efficiency of Biologic Drugs in Moderate to Severe Plaque Psoriasis. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:546-553. [PMID: 30851873 DOI: 10.1016/j.ad.2018.10.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Psoriasis is a chronic inflammatory skin disease with an estimated prevalence in Spain of 2.3% of the population. Approximately 30% of patients have moderate-to-severe forms. Treatment with biologic agents is proving to be a step forward in the management of the disease, although these treatments are very expensive. The objective of this study was to determine the efficiency, in terms of cost per number needed to treat (NNT), of the biologic drugs available in Spain for the treatment of moderate to severe plaque psoriasis. METHODS NNT data were obtained from a network meta-analysis that included all randomized clinical trials of biologic drugs sold in Spain. The cost of each treatment was calculated based on the approved dosage for the first year of treatment, as indicated in the Summary of Product Characteristics. These data were used to calculate the cost per NNT of the drugs for various PASI scores (75, 90, and 100). A sensitivity analysis was performed taking into consideration only the PASI-response measurement time (after 10, 12, or 16 weeks, depending on the drug). RESULTS The order of efficiency, from most to least efficient, in the case of a PASI 75 response was ixekizumab > ustekinumab 45mg > ustekinumab 90mg > secukinumab > infliximab > etanercept > adalimumab. The order for PASI 90 was ixekizumab >secukinumab >ustekinumab 45mg > ustekinumab 90mg > infliximab > adalimumab > etanercept. The order for PASI 100 was ixekizumab > secukinumab > infliximab > ustekinumab 90mg > ustekinumab 45mg > adalimumab > etanercept. The sensitivity analysis showed some changes in the order, depending on the response-assessment period. CONCLUSIONS The findings show a link between the efficacy of the biologic therapies available in Spain for the treatment of moderate-to-severe plaque psoriasis and their efficiency. Ixekizumab had the lowest cost per NNT for all PASI-response scores (75, 90, and 100) during the first year of treatment.
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Affiliation(s)
- M Núñez
- Eli Lilly and Company, Madrid, España.
| | - T Huete
- Eli Lilly and Company, Madrid, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | | | - S Hartz
- Eli Lilly and Company, Surrey, Reino Unido
| | - T Dilla
- Eli Lilly and Company, Madrid, España
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Johansson E, Nuñez M, Svedbom A, Dilla T, Hartz S. Cost effectiveness of ixekizumab versus secukinumab in the treatment of moderate-to-severe plaque psoriasis in Spain. CLINICOECONOMICS AND OUTCOMES RESEARCH 2018; 10:747-759. [PMID: 30519064 PMCID: PMC6237133 DOI: 10.2147/ceor.s167727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Currently, several biologic agents are available for the treatment of moderate-to-severe plaque psoriasis, including newer agents with similar mechanisms of action and efficacy; therefore, there is a need to evaluate their efficiency in terms of cost effectiveness. OBJECTIVE This study evaluates the cost effectiveness of recently approved interleukin (IL)-17A antagonists, ixekizumab and secukinumab, for the treatment of moderate-to-severe plaque psoriasis from the perspective of the Spanish National Health System (NHS). MATERIALS AND METHODS A Markov model with a lifetime horizon was developed to compare the cost effectiveness of ixekizumab vs. secukinumab in a hypothetical cohort of patients with moderate-to-severe plaque psoriasis. The model used monthly cycles and included four health states: a 12-week induction period, treatment maintenance, best supportive care (BSC), and death. Patients meeting response criteria at the end of the induction period transitioned to maintenance therapy, whereas non-responders transitioned to BSC. It was assumed that, each year, 20% of patients receiving maintenance therapy would discontinue treatment. The model incorporated data from various sources, including published literature, a network meta-analysis, and expert opinion for some variables. RESULTS Ixekizumab was dominant over secukinumab in that it gained 0.037 more quality-adjusted life years (QALYs) and saved €1951 in total costs over the lifetime horizon. Probabilistic sensitivity analysis showed a 96.6% likelihood that ixekizumab would be cost effective at a threshold of €30,000 per QALY gained. CONCLUSION For the treatment of moderate-to-severe plaque psoriasis in Spain, ixekizumab provided additional QALYs and potential savings for the Spanish NHS compared with secukinumab. Since the magnitude of the differences in costs and QALYs was modest, other factors such as patient preferences (eg, for number of injections) and long-term safety (eg, related to time on the market) may also be important for guiding clinical decisions.
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Affiliation(s)
- Erin Johansson
- Access, Commercialisation & Communications, ICON plc, Stockholm, Sweden,
| | - Mercedes Nuñez
- Health Outcomes and Real World Evidence, Eli Lilly, Madrid, Spain
| | - Axel Svedbom
- Access, Commercialisation & Communications, ICON plc, Stockholm, Sweden,
| | - Tatiana Dilla
- Health Outcomes and Real World Evidence, Eli Lilly, Madrid, Spain
| | - Susanne Hartz
- Global Patient Outcomes and Real World Evidence International, Eli Lilly, Surrey, UK
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12
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Colombo GL, Di Matteo S, Martinotti C, Jugl SM, Gunda P, Naclerio M, Bruno GM. Budget impact model of secukinumab for the treatment of moderate-to-severe psoriasis, psoriatic arthritis, and ankylosing spondylitis in Italy: a cross-indication initiative. CLINICOECONOMICS AND OUTCOMES RESEARCH 2018; 10:477-491. [PMID: 30214261 PMCID: PMC6121773 DOI: 10.2147/ceor.s171560] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective Secukinumab, a fully human monoclonal IgG1 antibody that selectively neutralizes the proinflammatory cytokine IL-17A, has been approved in Europe in 2015 for the treatment of adult patients with moderate-to-severe plaque psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS). This analysis assessed the budget impact of introduction of secukinumab to the Italian market for all three indications from the perspective of the Italian National Health Service. Materials and methods A cross-indication budget impact model was developed and included biologic-treated adult patients diagnosed with psoriasis, PsA, and AS. The analyses were conducted over a 3-year time horizon and included direct costs (drug therapy costs, administration costs, diseases-related costs, and adverse events costs). Model input parameters (epidemiology, market share projections, resource use, and costs) were obtained from the published literature and other Italian sources. The robustness of the results was tested via one-way sensitivity analyses: secukinumab cost, secukinumab market share, intravenous administration costs, and adverse events costs were varied by ±10%. Results The total patient population for secukinumab over the 3-year timeframe was projected to be 6,648 in the first year, increasing to 12,001 in the third year, for all three indications combined (psoriasis, PsA, and AS). Compared to a scenario without secukinumab in the market, the introduction of secukinumab in the market for the treatment of psoriasis, PsA, and AS showed a cumulative 3-year incremental budget impact of −5%, corresponding to savings of €66.1 million and per patient savings of about €1,855. The majority of the cost savings came from the adoption of secukinumab in AS (58%), followed by PsA (29%) and psoriasis (13%). Sensitivity analyses confirmed the robustness of the results. Conclusion Results from this cross-indication budget impact model show that secukinumab is a cost-saving option for the treatment of PsA, AS, and psoriasis patients in Italy.
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Affiliation(s)
- Giorgio L Colombo
- Department of Drug Science, Pavia University, Pavia, Italy, .,S.A.V.E. S.r.l. Studi Analisi Valutazioni Economiche Health Economics & Outcomes Research - research center, Milan, Italy,
| | - Sergio Di Matteo
- S.A.V.E. S.r.l. Studi Analisi Valutazioni Economiche Health Economics & Outcomes Research - research center, Milan, Italy,
| | - Chiara Martinotti
- S.A.V.E. S.r.l. Studi Analisi Valutazioni Economiche Health Economics & Outcomes Research - research center, Milan, Italy,
| | | | - Praveen Gunda
- Novartis Healthcare Private Limited, Hyderabad, India
| | | | - Giacomo M Bruno
- S.A.V.E. S.r.l. Studi Analisi Valutazioni Economiche Health Economics & Outcomes Research - research center, Milan, Italy,
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13
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Augustin M, McBride D, Gilloteau I, O'Neill C, Neidhardt K, Graham CN. Cost-effectiveness of secukinumab as first biologic treatment, compared with other biologics, for moderate to severe psoriasis in Germany. J Eur Acad Dermatol Venereol 2018; 32:2191-2199. [PMID: 29729105 DOI: 10.1111/jdv.15047] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 04/13/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin 17A, has demonstrated strong and sustained efficacy in adults with moderate to severe psoriasis in clinical trials. OBJECTIVE This analysis compared the cost per responder of secukinumab as first biologic treatment of moderate to severe psoriasis, with adalimumab, infliximab, etanercept and ustekinumab in Germany. METHODS A 52-week decision-tree model was developed. Response to treatment was assessed based on the likelihood of achieving a predefined Psoriasis Area and Severity Index (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. A German healthcare system perspective was adopted. Clinical efficacy data were obtained from a mixed-treatment comparison; 2016 resource unit costs from national sources; and adverse events and discontinuation rates from the literature. We calculated cost per PASI 90 responder over week 16 and week 52, as well as cost per sustained responder between weeks 16 and 52. RESULTS Secukinumab had the lowest cost per PASI 90 responder over 16 weeks (€18 026) compared with ustekinumab (€18 080), adalimumab (€23 499), infliximab (€29 599) and etanercept (€34 037). Over 52 weeks, costs per PASI 90 responder ranged from €42 409 (secukinumab) to €70 363 (etanercept). Likewise, secukinumab had the lowest cost per sustained 52-week PASI 90 responder (€22 690) compared with other biologic treatments. Sensitivity analyses, excluding patient copayments, showed similar results. CONCLUSIONS First biologic treatment with secukinumab for moderate to severe psoriasis is cost-effective, with lowest cost per responder compared with other biologic treatments in Germany.
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Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D McBride
- RTI Health Solutions, Manchester, UK
| | | | - C O'Neill
- Novartis Ireland Limited, Dublin, Ireland
| | | | - C N Graham
- RTI Health Solutions, Research Triangle Park, NC, USA
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14
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Dogra S, Bishnoi A, Narang T, Handa S. Long-term remission induced by secukinumab in a 13-year-old boy having recalcitrant chronic erythrodermic psoriasis. Dermatol Ther 2018; 31:e12611. [DOI: 10.1111/dth.12611] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 11/18/2017] [Accepted: 03/18/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Sunil Dogra
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research, Sector 12; Chandigarh India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research, Sector 12; Chandigarh India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research, Sector 12; Chandigarh India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research, Sector 12; Chandigarh India
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15
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Lozano-Wilhelmi M. From Registry Data to Real-Life Experiences: A Holistic Perspective of Psoriasis Treatment. EUROPEAN MEDICAL JOURNAL 2018. [DOI: 10.33590/emj/10314997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Registries provide very high-quality data on the persistence of different therapies in the real world and can be used to compare and guide therapeutic guidelines. Dr Warren gave an overview of the different types of registries that capture data on patients with psoriasis. Furthermore, he discussed findings from the British Association of Dermatologists Biological Interventions Register (BADBIR), the Psoriasis Longitudinal Assessment and Registry (PSOLAR), and the Danish Biologic Interventions Registry (DERMBIO) data that help to gain insight on how best to prescribe drugs in a clinical setting. Prof Puig and Prof Gniadecki presented cases encountered in clinical practice to illustrate how real-world data can support the clinical decision-making process. Throughout their presentations, Prof Puig and Prof Gniadecki engaged the audience in interactive discussion on how to improve patient monitoring and management of comorbidities, and addressed issues such as drug survival, safety, and economics.
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