Kuznik A, Bego-Le-Bagousse G, Eckert L, Gadkari A, Simpson E, Graham CN, Miles L, Mastey V, Mahajan P, Sullivan SD. Economic evaluation of dupilumab for the treatment of moderate-to-severe atopic dermatitis in adults. Dermatol Ther. 2017 Dec;7(4):493-505. doi: 10.1007/s13555-017-0201-6

INTRODUCTION: Dupilumab significantly improves signs and symptoms of atopic dermatitis (AD), including pruritus, symptoms of anxiety and depression, and health-related quality-of-life versus placebo in adults with moderate-to-severe AD. Since the cost-effectiveness of dupilumab has not been evaluated, the objective of this analysis was to estimate a value-based price range in which dupilumab would be considered cost-effective compared with supportive care (SC) for treatment of moderate-to-severe AD in an adult population.

METHODS: A health economic model was developed to evaluate from the U.S. payer perspective the long-term costs and benefits of dupilumab treatment administered every other week (q2w). Dupilumab q2w was compared with SC; robustness of assumptions and results were tested using sensitivity and scenario analyses. Clinical data were derived from the dupilumab LIBERTY AD SOLO trials; healthcare use and cost data were from health insurance claims histories of adult patients with AD. The annual price of maintenance therapy with dupilumab to be considered cost effective was estimated for decision thresholds of $100,000 and $150,000 per quality-adjusted life-year (QALY) gained.

RESULTS: In the base-case, the annual maintenance price for dupilumab therapy to be considered cost effective would be $28,770 at a $100,000 per QALY gained threshold, and $39,940 at a $150,000 threshold. Results were generally robust to parameter variations in one-way and probabilistic sensitivity analyses.

CONCLUSIONS: Dupilumab q2w compared with SC is cost-effective for the treatment of moderate-to-severe AD in U.S. adults at an annual price of maintenance therapy in the range of $29,000 to $40,000 at the $100,000 to $150,000 per QALY thresholds.

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