Cost-efficacy of biologic therapies for moderate to severe psoriasis from the perspective of the Taiwanese healthcare system

Abstract

Background: Biologic therapies are more effective than conventional therapies in the treatment of psoriasis, but they are also more costly.

Objectives: The aim of this study was to compare the cost-efficacy of etanercept, adalimumab, and ustekinumab therapies in the treatment of moderate to severe psoriasis in a Taiwanese setting.

Methods: We conducted a meta-analysis of randomized, placebo-controlled trials to calculate the incremental efficacy of etanercept, adalimumab, and ustekinumab, respectively, in affecting a reduction of ≥75% in score on the Psoriasis Area and Severity Index (PASI 75). The base, best case, and worst case incremental cost-effectiveness ratios (ICERs) for one subject to achieve PASI 75 were calculated for the purposes of economic analysis.

Results: One-year ICERs per PASI 75 responder were US$ 39,709 (best scenario US$ 36,400; worst scenario US$ 43,680), US$ 23,711 (best scenario US$ 22,633; worst scenario US$ 25,319), and US$ 26,329 (best scenario US$ 24,780; worst scenario US$ 27,623) for etanercept, adalimumab, and ustekinumab, respectively. Two year ICERs per PASI 75 responder were US$ 71,973 (best scenario US$ 65,975; worst scenario US$ 79,170), US$ 62,665 (best scenario US$ 59,817; worst scenario US$ 66,914), and US$ 52,657 (best scenario US$ 49,560; worst scenario US$ 55,427) for etanercept, adalimumab, and ustekinumab, respectively.

Conclusions: In a Taiwanese setting, adalimumab and ustekinumab had lower 1-year costs per PASI 75 responder than etanercept, and ustekinumab had the lowest 2-year cost per PASI 75 responder.