Cost-Effectiveness Analysis of IDP-126, a Topical Triple Therapy, for the Treatment of Acne Vulgaris From the Perspective of Canadian Public Payers

OBJECTIVES: Acne vulgaris is a highly prevalent skin condition with a significant burden of disease, related to the visibility of facial lesions, psychosocial impact and sequelae. Combination topical products offer improved efficacy and convenience, which are associated with better adherence and outcomes. IDP-126 is a novel triple-combination fixed-dose topical gel of clindamycin (1.2%), adapalene (0.15%), and benzoyl peroxide (3.1%) for the treatment of acne vulgaris. This study evaluated the cost-effectiveness of IDP-126 compared to other topical treatments for acne from the perspective of Canadian public payers.

METHODS: Existing acne economic models often fail to capture small but clinically meaningful improvements in acne lesion counts. Therefore, a de novo Markov model was developed to capture as small as a one acne lesion count change. A regression model was derived to estimate utilities based on total lesion count. Informed by an indirect treatment comparison, the model estimated incremental costs and benefits of topical therapies for the treatment of acne over a 60-week time-horizon.

RESULTS: Five topical therapy categories were considered as relevant comparators of IDP-126. IDP-126 resulted in the highest quality-adjusted life years (QALY) among all treatments. Compared to the lowest cost comparator, antibiotic monotherapy, IDP-126 exhibited 0.038 incremental QALYs at an incremental cost of $1,479, resulting in an incremental cost-effectiveness ratio (ICER) of $39,080/QALY. In sequential analysis, topical retinoid monotherapies, topical retinoid/BPO, and antibiotic/retinoid fixed dose combinations were dominated by antibiotic/BPO fixed dose combinations. IDP-126 resulted in a sequential ICER of $62,967/QALY vs topical antibiotic/BPO fixed-dose combinations.

CONCLUSIONS: The results of this study suggest that IDP-126 provides the greatest QALY benefits among the treatments considered, resulting in a very moderate ICER. In addition to being a cost-effective alternative, IDP-126 fulfils an unmet need in acne topical therapies by providing an optimized drug concentration targeting three of the four acne pathogenic pathways.