REAL-WORLD COST-EFFECTIVENESS AND OPPORTUNITY COSTS OF ANTI-IL-17/23 VERSUS ANTI-TNF? THERAPIES FOR PSORIASIS USING DLQI
Author(s)
Rafael Gama, MBA, MD1, Paula Heberle, MBA2, Sergio M. Menoncin, MSc2, Ana C. Maciel, BSc2, Daniela Toigo, MBA2, Ricardo Bueno, BA, MHA, PhD3, Nanci Utida, MD4, Ana Cláudia de Medeiros, BSc2, Aline Kroger, BSc2;
1Unimed Blumenau, CURITIBA, Brazil, 2Unimed Blumenau, Blumenau, Brazil, 3Researcher, São Paulo, Brazil, 4USP, Sao Paulo, Brazil
1Unimed Blumenau, CURITIBA, Brazil, 2Unimed Blumenau, Blumenau, Brazil, 3Researcher, São Paulo, Brazil, 4USP, Sao Paulo, Brazil
OBJECTIVES: To evaluate the comparative cost-effectiveness and budgetary opportunity costs of Anti-IL-17/23 versus Anti-TNFα biosimilars for psoriasis from a Brazilian private healthcare payer perspective.
METHODS: Retrospective observational study using real-world data from a private insurer (130,000 lives) over 24 months (2023-2025). Patients were grouped by therapeutic class. We analyzed average annual treatment costs (including induction) and DLQI scores at 13-15 months. The Incremental Cost-Effectiveness Ratio (ICER) was adapted using the incremental DLQI as the primary outcome. Currency was converted at R$ 5.5 : USD 1.
RESULTS: 44 patients were analyzed (Anti-IL n=38; Anti-TNFα n=6). Mean annual costs and DLQI scores were USD 28,266/2.9 for Anti-IL and USD 6,250/4.2 for Anti-TNFα. The incremental DLQI gain for Anti-IL was 1.3 points, resulting in an ICER of USD 16,935 per point. Anti-IL therapies represented a 450% cost increase per patient compared to Anti-TNFα biosimilars. Under fixed budget constraints, the opportunity cost was 2.8 patients treated with Anti-TNFα for every single patient on Anti-IL.
CONCLUSIONS: Both drug classes obtained DLQI scores below 5, indicating a low impact on quality of life. Despite greater clinical efficacy (PASI), anti-IL therapies were substantially less cost-effective than anti-TNFα biosimilars. The DLQI proved to be a pragmatic and patient-centered indicator for value-based healthcare (VBHC) models, aligning with the ISPOR Value Flower model. The results support Step-Up access protocol strategies that prioritize biosimilars to maximize population health gains within limited budgets.
METHODS: Retrospective observational study using real-world data from a private insurer (130,000 lives) over 24 months (2023-2025). Patients were grouped by therapeutic class. We analyzed average annual treatment costs (including induction) and DLQI scores at 13-15 months. The Incremental Cost-Effectiveness Ratio (ICER) was adapted using the incremental DLQI as the primary outcome. Currency was converted at R$ 5.5 : USD 1.
RESULTS: 44 patients were analyzed (Anti-IL n=38; Anti-TNFα n=6). Mean annual costs and DLQI scores were USD 28,266/2.9 for Anti-IL and USD 6,250/4.2 for Anti-TNFα. The incremental DLQI gain for Anti-IL was 1.3 points, resulting in an ICER of USD 16,935 per point. Anti-IL therapies represented a 450% cost increase per patient compared to Anti-TNFα biosimilars. Under fixed budget constraints, the opportunity cost was 2.8 patients treated with Anti-TNFα for every single patient on Anti-IL.
CONCLUSIONS: Both drug classes obtained DLQI scores below 5, indicating a low impact on quality of life. Despite greater clinical efficacy (PASI), anti-IL therapies were substantially less cost-effective than anti-TNFα biosimilars. The DLQI proved to be a pragmatic and patient-centered indicator for value-based healthcare (VBHC) models, aligning with the ISPOR Value Flower model. The results support Step-Up access protocol strategies that prioritize biosimilars to maximize population health gains within limited budgets.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE395
Topic
Economic Evaluation
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin), SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), STA: Biologics & Biosimilars