A COST-EFFECTIVENESS ANALYSIS OF 1.5% RUXOLITINIB CREAM COMPARED WITH SYSTEMIC TREATMENTS FOR ADULT PATIENTS WITH MODERATE ATOPIC DERMATITIS IN GERMANY
Author(s)
ELLA JURK, MSc1, Svenja Schwarz, MSc1, Mike Raddatz, MSc1, York Francis Zoellner, PhD2, Nicolas Plommet, MSc3, Malte Hellwig, PhD4.
1IPE Institute for Policy Evaluation GmbH - HEOR, Frankfurt am Main, Germany, 2Hamburg University of Applied Sciences, Hamburg, Germany, 3Incyte Biosciences International Sàrl, Morges, Switzerland, 4Incyte Biosciences Germany GmbH, Munich, Germany.
1IPE Institute for Policy Evaluation GmbH - HEOR, Frankfurt am Main, Germany, 2Hamburg University of Applied Sciences, Hamburg, Germany, 3Incyte Biosciences International Sàrl, Morges, Switzerland, 4Incyte Biosciences Germany GmbH, Munich, Germany.
OBJECTIVES: Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by pruritus, relapsing lesions, and quality-of-life impairment. Adults with moderate AD require systemic therapy when topical corticosteroids or topical calcineurin inhibitors are ineffective, not tolerated, or contraindicated. This study assessed the cost-effectiveness of ruxolitinib cream versus systemic therapies.
METHODS: A hybrid cost-effectiveness model was developed from the German statutory health insurance (SHI) perspective, combining a 52-week decision tree with a lifetime Markov model. Patients initiated ruxolitinib cream or a comparator. A ≥75% improvement in Eczema Area and Severity Index (EASI-75) was used to define response. Non-responders entered a weighted basket of remaining active therapies; responders remained on initial treatment in the Markov model until loss of response or discontinuation, then joined the basket until death. Comparators were biologics, oral Janus kinase inhibitors, immunosuppressants, and best supportive care (BSC). Model inputs were informed by a randomized phase 3b study, real-world evidence, indirect treatment comparison, and published literature. Costs included drug acquisition, healthcare resource use, adverse events, flares, and disease management. Costs and quality-adjusted life-years (QALYs) were discounted at 3% annually. One-way, probabilistic, and scenario sensitivity analyses were conducted.
RESULTS: Compared with systemic therapies, ruxolitinib cream was associated with lower total costs and higher QALYs, resulting in dominance across all comparators. Lifetime cost savings ranged from €49,000 to €92,000, and QALY gains from 0.11 to 0.16. One-way sensitivity analyses identified discontinuation rates, response rates, and long-term ruxolitinib cream use as main drivers. Dominance was maintained across all tested deterministic scenarios, including time horizon, concomitant use, methotrexate inclusion, equalized discontinuation, and response assessment timepoint, with consistent results in the probabilistic sensitivity analysis.
CONCLUSIONS: From the German SHI perspective, ruxolitinib cream was dominant versus all comparators for adults with moderate AD. These findings suggest ruxolitinib cream may provide clinical value while reducing costs.
METHODS: A hybrid cost-effectiveness model was developed from the German statutory health insurance (SHI) perspective, combining a 52-week decision tree with a lifetime Markov model. Patients initiated ruxolitinib cream or a comparator. A ≥75% improvement in Eczema Area and Severity Index (EASI-75) was used to define response. Non-responders entered a weighted basket of remaining active therapies; responders remained on initial treatment in the Markov model until loss of response or discontinuation, then joined the basket until death. Comparators were biologics, oral Janus kinase inhibitors, immunosuppressants, and best supportive care (BSC). Model inputs were informed by a randomized phase 3b study, real-world evidence, indirect treatment comparison, and published literature. Costs included drug acquisition, healthcare resource use, adverse events, flares, and disease management. Costs and quality-adjusted life-years (QALYs) were discounted at 3% annually. One-way, probabilistic, and scenario sensitivity analyses were conducted.
RESULTS: Compared with systemic therapies, ruxolitinib cream was associated with lower total costs and higher QALYs, resulting in dominance across all comparators. Lifetime cost savings ranged from €49,000 to €92,000, and QALY gains from 0.11 to 0.16. One-way sensitivity analyses identified discontinuation rates, response rates, and long-term ruxolitinib cream use as main drivers. Dominance was maintained across all tested deterministic scenarios, including time horizon, concomitant use, methotrexate inclusion, equalized discontinuation, and response assessment timepoint, with consistent results in the probabilistic sensitivity analysis.
CONCLUSIONS: From the German SHI perspective, ruxolitinib cream was dominant versus all comparators for adults with moderate AD. These findings suggest ruxolitinib cream may provide clinical value while reducing costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE426
Topic
Economic Evaluation, Epidemiology & Public Health, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)