Cost-effectiveness analysis of secukinumab versus other biologics and apremilast in the treatment of active Psoriatic arthritis : a Finnish perspective

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Purmonen , T , Puolakka , K , Bhattacharyya , D , Jain , M & Martikainen , J 2018 , ' Cost-effectiveness analysis of secukinumab versus other biologics and apremilast in the treatment of active Psoriatic arthritis : a Finnish perspective ' , Cost Effectiveness and Resource Allocation , vol. 16 , 56 . https://doi.org/10.1186/s12962-018-0162-3

Title: Cost-effectiveness analysis of secukinumab versus other biologics and apremilast in the treatment of active Psoriatic arthritis : a Finnish perspective
Author: Purmonen, Timo; Puolakka, Kari; Bhattacharyya, Devarshi; Jain, Minal; Martikainen, Janne
Contributor organization: HYKS erva
Date: 2018-11-16
Language: eng
Number of pages: 10
Belongs to series: Cost Effectiveness and Resource Allocation
ISSN: 1478-7547
DOI: https://doi.org/10.1186/s12962-018-0162-3
URI: http://hdl.handle.net/10138/297711
Abstract: ObjectiveTo study cost-effectiveness of an interleukin (IL)-17A inhibitor secukinumab, with other biologics and apremilast in patients with Psoriatic arthritis (PsA) from payer perspective in Finland.MethodsIn this semi-Markov model, subcutaneous (SC) secukinumab was compared with SC treatments etanercept and its biosimilar, certolizumab pegol, adalimumab and its biosimilar, golimumab, ustekinumab, intravenous (IV) treatment infliximab, as well as oral non-biologic apremilast. Patients without prior exposure (naive) to biologics and without moderate to severe psoriasis were considered for secukinumab 150mg group. Secukinumab 300mg group included naive patients with moderate to severe psoriasis and all patients with prior biologic exposure. The PsA Response Criteria (PsARC) at 12-week was primary criteria for treatment response. Other clinical as well as cost related model inputs were derived from relevant clinical trials as well as Finnish publications. The key model outcomes were quality-adjusted life years and incremental cost-effectiveness ratio. An annual 3% discount rate was applied to all future costs and benefits. Model input variations were assessed through sensitivity analyses and alternative scenario analyses.ResultsFor a lifetime horizon (60years), secukinumab 150mg dominated all branded SC biologics and apremilast with highest QALY of 8.01 and lowest lifetime cost of Euro187,776, while it was cost-effective against IV infliximab among biologic-naive patients without moderate to severe psoriasis. Secukinumab 300mg was cost-effective against all branded SC biologics and apremilast and dominated IV infliximab among biologic-naive patients with moderate to severe psoriasis, while it was cost-effective in biologic experienced patients. With the one-way sensitivity analysis, PsARC response, drug acquisition cost, and health assessment questionnaire score were the most important parameters affecting the outcomes. Across all treatment groups, patients on secukinumab were most likely to achieve highest net monetary benefit than other competitors in probabilistic sensitivity analysis. With alternative scenario analysis, results largely remained unchanged.ConclusionsSecukinumab is a cost-effective treatment for PsA patients from a Finnish payer's perspective.
Subject: Psoriatic arthritis
Cost-effectiveness
Biologics
Secukinumab
Incremental cost effectiveness ratio
Quality adjusted life years
PHARMACOLOGICAL THERAPIES
TREATMENT RECOMMENDATIONS
RHEUMATOID-ARTHRITIS
ECONOMIC-EVALUATION
EUROPEAN LEAGUE
DOUBLE-BLIND
FUTURE 2
INFLIXIMAB
HEALTH
ETANERCEPT
3142 Public health care science, environmental and occupational health
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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