Cost-Effectiveness Analysis of Secukinumab for Moderate to Severe Hidradenitis Suppurativa in Portugal
Author(s)
Joao Malhadeiro1, Nilza Gonçalves, MSc2, Severina Moreira, MSc3, Jorge Felix Parreia, MSc4, João Rocha, MSc5.
1Value & Access Lead, Novartis, Porto Salvo, Portugal, 2NOVARTIS, Lisbon, Portugal, 3Novartis, Porto Salvo, Portugal, 4Exigo Consultores LDA, Lisboa, Portugal, 5Exigo Consultores LDA, Lisbon, Portugal.
1Value & Access Lead, Novartis, Porto Salvo, Portugal, 2NOVARTIS, Lisbon, Portugal, 3Novartis, Porto Salvo, Portugal, 4Exigo Consultores LDA, Lisboa, Portugal, 5Exigo Consultores LDA, Lisbon, Portugal.
OBJECTIVES: Hidradenitis Suppurativa (HS) is a chronic inflammatory disease significantly impacting patient quality of life. Secukinumab is a monoclonal antibody targeting interleukin-17A which plays an important role in HS inflammatory processes. This analysis aims to assess the cost-effectiveness of secukinumab in moderate to severe HS patients who were previously exposed to or have contraindications for adalimumab, within the Portuguese healthcare system
METHODS: We developed a lifetime cost-effectiveness model to estimate the costs and consequences of treating moderate to severe HS in adults. The comparator was Standard of Care (SoC), encompassing general care, antibiotics (doxycycline or rifampicin + clindamycin), retinoids, and/or surgical procedures tailored to patient and disease severity. The model's framework included three health states: ‘responder’, ‘non-responder’, and ‘death’. These states were defined by the percentage improvement in the Hidradenitis Suppurativa Clinical Response (HiSCR) from baseline. The model used 4-week cycles and considered specific parameters for patient distribution between ‘responder’ and ‘non-responder’ states during initial treatment. Patients discontinuing initial treatment (for any reason other than death) were assumed to remain in the ‘non-responder’ state until death. The analysis was conducted from a payer's perspective and considered a 4% discount rate. Uncertainty was assessed through probabilistic and deterministic sensitivity analyses.
RESULTS: Under reference conditions, SEC Q4W (secukinumab every 4 weeks) and SEC Q4W-Q2W (initially every 4 weeks, then every 2 weeks) yielded 1.39 and 1.79 additional Quality-Adjusted Life Years (QALYs), respectively, compared to SoC. These treatments were associated with cost increases over SoC of €13,131 and €33,618 per patient, respectively. Comparing alternatives, SEC Q4W and SEC Q4W-Q2W resulted in Incremental Cost-Effectiveness Ratios (ICERs) versus SoC of €9,463/QALY and €18,826/QALY, respectively.
CONCLUSIONS: Our results demonstrate that secukinumab is cost-effective compared to SoC in moderate to severe HS patients who were previously exposed to or have contraindications for adalimumab, within the Portuguese healthcare system perspective.
METHODS: We developed a lifetime cost-effectiveness model to estimate the costs and consequences of treating moderate to severe HS in adults. The comparator was Standard of Care (SoC), encompassing general care, antibiotics (doxycycline or rifampicin + clindamycin), retinoids, and/or surgical procedures tailored to patient and disease severity. The model's framework included three health states: ‘responder’, ‘non-responder’, and ‘death’. These states were defined by the percentage improvement in the Hidradenitis Suppurativa Clinical Response (HiSCR) from baseline. The model used 4-week cycles and considered specific parameters for patient distribution between ‘responder’ and ‘non-responder’ states during initial treatment. Patients discontinuing initial treatment (for any reason other than death) were assumed to remain in the ‘non-responder’ state until death. The analysis was conducted from a payer's perspective and considered a 4% discount rate. Uncertainty was assessed through probabilistic and deterministic sensitivity analyses.
RESULTS: Under reference conditions, SEC Q4W (secukinumab every 4 weeks) and SEC Q4W-Q2W (initially every 4 weeks, then every 2 weeks) yielded 1.39 and 1.79 additional Quality-Adjusted Life Years (QALYs), respectively, compared to SoC. These treatments were associated with cost increases over SoC of €13,131 and €33,618 per patient, respectively. Comparing alternatives, SEC Q4W and SEC Q4W-Q2W resulted in Incremental Cost-Effectiveness Ratios (ICERs) versus SoC of €9,463/QALY and €18,826/QALY, respectively.
CONCLUSIONS: Our results demonstrate that secukinumab is cost-effective compared to SoC in moderate to severe HS patients who were previously exposed to or have contraindications for adalimumab, within the Portuguese healthcare system perspective.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE219
Topic
Economic Evaluation, Health Technology Assessment
Disease
Biologics & Biosimilars, Sensory System Disorders (Ear, Eye, Dental, Skin)