OBJECTIVES: Secukinumab (SEC300), an IL-17A antibody, was recently approved as highly effective therapy for moderate-to-severe plaque psoriasis (PSO). We examined the cost-effectiveness of SEC300 compared against other systemic biologic drugs: adalimumab (ADA), etanercept (ETA), infliximab (INF), ustekinumab (UST) 45 and 90 mg, and standard of care (SOC - cyclosporine and methotrexate) for plaque psoriasis, in the Italian National Health System (NHS) setting.
METHODS: A previous cost-effectiveness model was adapted to the Italian healthcare setting. The model was designed to consider the clinical benefits, resource use and costs related to SEC300. A decision tree reflecting response to treatment (PASI change less than 50, 50-75, 75-90, 90-99, 100) fed into a long-term Markov model with health states related to treatment continuation, dropout, and death. Clinical data (PASI change scores, percentage of adverse events, discontinuation rate) and utility scores were derived from clinical trials as well as from published evidence on Italian patients. The perspective of the model is the Italian NHS, therefore only direct medical costs (drug prices, inpatient and outpatient hospital tariffs, etc.) were taken in account. Both costs and benefits were discounted at 3% according to Italian National Guidelines for Health Economics Evaluations. Incremental cost-effectiveness ratios (ICERs) were calculated.
RESULTS: At 10 years, SEC300 is a dominant (less costly and more effective) option compared with UST45 and UST90. It is a cost-effective option – with a threshold less than EUR50,000/QALY gained as per National Health Economics Evaluation Guidelines – vs. ADA, IFN, ETA, and SOC with an ICERs of EUR37,252, EUR48,949, EUR21,943 and EUR41,896, respectively. The sensitivity analysis demonstrated the robustness of model results.
CONCLUSIONS: The model shows that SEC300 is a cost-effective option when compared to other biologic agents and SOC currently funded by NHS in Italy for the treatment of moderate-to-severe plaque psoriasis.
