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. 2020 Dec 1;100(19):adv00340.
doi: 10.2340/00015555-3692.

Health Economic Consequences of a Tightly Controlled Dose Reduction Strategy for Adalimumab, Etanercept and Ustekinumab Compared with Standard Psoriasis Care: A Cost-utility Analysis of the CONDOR Study

Selma Atalay  1 , Juul M P A van den Reek, Marisol E Otero, Marcellus D Njoo, Johannes M Mommers, Paul M Ossenkoppele, Marjolein I Koetsier, Maartje M Berends, Peter C M van de Kerkhof, Hans M M Groenewoud, Alfons A den Broeder, Elke M G J de Jong, Wietske Kievit
Affiliations

Health Economic Consequences of a Tightly Controlled Dose Reduction Strategy for Adalimumab, Etanercept and Ustekinumab Compared with Standard Psoriasis Care: A Cost-utility Analysis of the CONDOR Study

Selma Atalay et al. Acta Derm Venereol. .

Abstract

A dose reduction strategy for adalimumab, etanercept and ustekinumab in patients with psoriasis who have stable and low disease activity has recently been compared with usual care in the CONDOR study (CONtrolled DOse Reduction) of biologics in patients with psoriasis with low disease activity. The aim of the current study was to perform a cost-utility analysis with a 12-month time horizon alongside this trial, using prospectively measured healthcare costs and quality-adjusted life years, based on Short-Form Six-Dimension utilities. Bootstrap analys-es were used to calculate the decremental cost-utility ratio and the incremental net monetary benefit. The dose reduction strategy resulted in a mean cost saving of €3,820 (95th percentile -€3,099 to -€4,509) per patient over a period of 12 months. There was an 83% chance that dose reduction would result in a reduction in quality adjusted life years (mean -0.02 (95th percentile -0.06 to 0.02). In conclusion, dose reduction of biologics resulted in substantial cost savings with an acceptable reduction in quality of life.

Keywords: CONDOR study; biologics; cost-utility; dose reduction strategy; psoriasis.

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Conflict of interest statement

Conflicts of interest: SA has served as clinical study investigator for Janssen Pharmaceuticals, Abbvie, Celgene and Novartis and received congress fee from Celgene. The current study is funded by a grant from ZonMW. All funding is not personal, but goes to the independent research fund of the department of dermatology of Radboud University Medical Center Nijmegen, the Netherlands; JMPAvdR served as clinical study investigator and/or scientific speaker for Janssen Pharmaceuticals, Abbvie and Celgene. The current study is funded by a grant from ZonMW. All funding is not personal, but goes to the independent research fund of the Department of Dermatology, Radboud University Medical Center Nijmegen, the Netherlands; MEO has served as a consultant for Eli Lilly; JMM received personal fees from Janssen-Cilag; PMO has served as a scientific adviser and received a medical advice board fee from Abbvie; PCMvdK. served as a consultant/lectureships and received personal fees from Celgene, Centocor, Allmirall, Amgen, Pfizer, Philips, Abbott, Eli Lilly, Galderma, Novartis, Jansen Pharmaceutica, Leo Pharma, Sandoz, Bristol Mayer Squib and Dermavant; AAdB received personal fees from Amgen, FRESENIUS, Boehringer, MSD, and Sandoz, grants from Celltrion, Abbvie, Biogen and congress fee from Roche and Cellgene; EMGJdJ has received research grants for the independent research fund of the department of dermatology of the Radboud University Medical Centre Nijmegen, the Netherlands from AbbVie, Pfizer, Novartis, Janssen Pharmaceutica and Leo Pharma. She has acted as consultant and/or paid speaker for and/or participated in research sponsored by companies that manufacture drugs used for the treatment of psoriasis including AbbVie, Janssen Pharmaceutica, Novartis, Lily, Celgene, Leo Pharma, UCB and Almirall. The current study is funded by a grant from ZonMW. All funding is not personal, but goes to the independent research fund of the department of dermatology of Radboud University Medical Center Nijmegen, the Netherlands. No other disclosers were reported. All authors meet the criteria of the International Committee of Medical Journal Editors Authorship.

Figures

Fig. 1
Fig. 1
Cost-utility plane and cost-utility acceptability curve. (a) Results of costs and utility estimations in cost-effectiveness (CE) plane, based on 1,000 bootstrapped replications. (b) Cost-effectiveness acceptability. iNBM: incremental net monetary benefit; WTA: willingness to accept; QALY: quality-adjusted life year.
Fig. 2
Fig. 2
Cost effectiveness acceptability curves for lower drug prices. (a) Analysis with 30% lower drug prices. (b) Analysis with 50% lower drug prices. (c) Analysis with 80% lower drug prices. iNBM: incremental net monetary benefit; WTA: willingness to accept.
See this image and copyright information in PMC

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