Presentation (CTI)

OBJECTIVES: This study compares the cost per responder (CpR) at the end of the first year of therapy for brodalumab with other approved biologic and subsequent entry biologic (SEB) drugs used in the treatment of moderate to severe plaque psoriasis in Canada.
METHODS: A literature review identified a published network meta-analysis (NMA) that evaluated long-term efficacy (48-56 weeks), including Psoriasis Area and Severity Index (PASI) 100 and PASI 90 responses across treatments for psoriasis. The CpR was calculated by dividing the treatment cost by the response rate, as defined by PASI 100 or PASI 90. The treatments (originators and available SEBs) included in this analysis were adalimumab, brodalumab, bimekizumab, etanercept, guselkumab, ixekizumab, risankizumab, secukinumab, and ustekinumab. Tildrakizumab, certolizumab, and infliximab were not part of the selected NMA and were therefore excluded from this analysis. Treatment costs were calculated using Health Canada approved dosing regimens for the first year of therapy and Ontario wholesale list prices from the IQVIA database as of October 2025. The primary analysis was based on PASI 100, and the secondary analysis on PASI 90. Sensitivity analyses were conducted from the perspective of provincial drug plans using list prices from provincial formularies.
RESULTS: Brodalumab had the lowest CpR based on PASI 100 ($31,043) compared with all other biologics (originators and SEBs) included in this analysis. Its CpR was 17.7% lower than risankizumab ($37,729), the originator biologic with the second-lowest CpR, and 31.3% lower than ustekinumab SEB ($45,178), the SEB with the lowest CpR. Brodalumab also had the lowest CpR based on PASI 90 ($22,156) compared with all other drugs.
CONCLUSIONS: At one year, brodalumab demontrates the greatest cost-effectiveness across PASI 100 and PASI 90 compared with other studied biologic therapies (originators and SEBs), providing optimal value for patients, prescribers, and payers.