NUMBER NEEDED TO TREAT AND ASSOCIATED COSTS PER ADDITIONAL RESPONDER OF BIOLOGIC THERAPIES IN ADULT PATIENTS WITH MODERATE TO SEVERE ATOPIC DERMATITIS: A US PAYER PERSPECTIVE
Author(s)
Marie Fournier, MSc1, Kerry Noonan, BA2, Andreas Kuznik, PhD3, Zhixiao Wang, PhD3.
1Sanofi, Gentilly, France, 2Sanofi, Cambridge, MA, USA, 3Regeneron Pharmaceuticals Inc., Sleepy Hollow, NY, USA.
1Sanofi, Gentilly, France, 2Sanofi, Cambridge, MA, USA, 3Regeneron Pharmaceuticals Inc., Sleepy Hollow, NY, USA.
OBJECTIVES: Dupilumab, lebrikizumab and nemolizumab are approved biologic therapies for patients with moderate-to-severe atopic dermatitis (AD) ineligible or with an inadequate response to topical therapies in the United States (US). The current analysis compared the number needed-to-treat (NNT) and the costs per additional responder (CPR) in adult patients with moderate-to-severe AD treated with these biologic therapies, from a US payer perspective.
METHODS: Two published Bucher indirect treatment comparisons, Stander et al. (dupilumab versus lebrikizumab, 2025) and Steinhoff et al. (dupilumab versus nemolizumab, 2026), informed the development of an economic model to estimate the NNT and incremental CPR. The model compared dupilumab, lebrikizumab, and nemolizumab, each in combination with topical therapy, using placebo-adjusted efficacy estimates derived from Bucher ITCs over a 16-week treatment period. Response to treatment was defined as a 75% reduction from the baseline in Eczema Area and Severity Index (EASI-75) at Week 16. NNT was calculated as the inverse of the absolute risk reduction versus standard of care for each biologic. Current US list prices based on RED BOOK (IBM Micromedex, 2024) were used for the drugs. Sensitivity analyses were done based on outcomes and time horizon variations.
RESULTS: The NNT to achieve one additional responder versus topical treatments alone was lower with dupilumab versus lebrikizumab (3 versus 5) and nemolizumab (3 versus 9) respectively, considering EASI-75 as the response measure. The CPR was higher for lebrikizumab ($183.8K versus $56.6K) and nemolizumab ($200.3K versus $56.6K) versus dupilumab. These results were consistent in the sensitivity analyses.
CONCLUSIONS: Dupilumab is associated with a lower NNT and approximately 3.2 and 3.5-times lower CPR, compared to lebrikizumab and nemolizumab respectively. These data suggest that dupilumab represents the cost-effective biologic option currently available for the management of moderate-to-severe AD.
METHODS: Two published Bucher indirect treatment comparisons, Stander et al. (dupilumab versus lebrikizumab, 2025) and Steinhoff et al. (dupilumab versus nemolizumab, 2026), informed the development of an economic model to estimate the NNT and incremental CPR. The model compared dupilumab, lebrikizumab, and nemolizumab, each in combination with topical therapy, using placebo-adjusted efficacy estimates derived from Bucher ITCs over a 16-week treatment period. Response to treatment was defined as a 75% reduction from the baseline in Eczema Area and Severity Index (EASI-75) at Week 16. NNT was calculated as the inverse of the absolute risk reduction versus standard of care for each biologic. Current US list prices based on RED BOOK (IBM Micromedex, 2024) were used for the drugs. Sensitivity analyses were done based on outcomes and time horizon variations.
RESULTS: The NNT to achieve one additional responder versus topical treatments alone was lower with dupilumab versus lebrikizumab (3 versus 5) and nemolizumab (3 versus 9) respectively, considering EASI-75 as the response measure. The CPR was higher for lebrikizumab ($183.8K versus $56.6K) and nemolizumab ($200.3K versus $56.6K) versus dupilumab. These results were consistent in the sensitivity analyses.
CONCLUSIONS: Dupilumab is associated with a lower NNT and approximately 3.2 and 3.5-times lower CPR, compared to lebrikizumab and nemolizumab respectively. These data suggest that dupilumab represents the cost-effective biologic option currently available for the management of moderate-to-severe AD.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE581
Topic
Economic Evaluation
Disease
Biologics & Biosimilars, Sensory System Disorders (Ear, Eye, Dental, Skin)