Cost-per-Responder Analysis of Bimekizumab (IL-17A/F Inhibitor) Against Il-23 Targeted Therapies for Psoriatic Arthritis in Spain, Based on Matching-Adjusted Indirect Comparisons

OBJECTIVES: Bimekizumab is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F in addition to IL-17A, recently approved to treat patients with active psoriatic arthritis (PsA) in the European Union. This study compares the cost-per-responder (CPR) of bimekizumab against IL-23 targeted therapies (guselkumab and risankizumab) for the treatment of patients with PsA in Spain.

METHODS: The CPR was calculated by dividing the average annual drug cost per patient by the response rates. Minimal disease activity (MDA), American College of Rheumatology (ACR) 50 and ACR70 response rates at week 52 from two published Matching-Adjusted Indirect Comparisons (MAIC) were used. Spanish list prices were considered, including the Royal Decree Law 8/2010 discount. Dosing regimens were informed by each treatment´s Summary of Product Characteristics (bimekizumab 160mg-Q4W, guselkumab 100mg-Q8W, and risankizumab 150mg-Q12W).

RESULTS: For MDA, bimekizumab had a lower CPR (€34,711 for biologic-naïve and €39,847 for TNFi-experienced patients) compared to guselkumab (€52,972 and €60,819, respectively) and bimekizumab CPR was also lower (€37,102 for biologic-naïve and €46,249 for TNFi-experienced patients) than risankizumab (€46,781 and €93,809, respectively). For ACR50, CPR for bimekizumab (€31,033 for biologic-naïve and €36,454 for TNFi-experienced patients) was lower compared to risankizumab (€40,947 and €81,705, respectively) and bimekizumab had a lower CPR (€29,602 for biologic-naïve and €33,325 for TNFi-experienced patients) compared to guselkumab (€33,928 and €41,891, respectively). For ACR70, CPR was also lower for bimekizumab (€37,603 for biologic-naïve and €48,961 for TNFi-experienced patients) compared to guselkumab (€59,069 and €68,997, respectively) and for bimekizumab (€43,253 for biologic-naïve and €55,839 for TNFi-experienced patients) compared to risankizumab (€68,455 and €170,480, respectively).

CONCLUSIONS: Based on published MAIC response rates for MDA, ACR 50 and ACR70 at week 52, the CPR analyses demonstrate it is more cost-efficient to treat patients with PsA in Spain with bimekizumab than with available IL-23 targeted therapies guselkumab and risankizumab.