COST-PER-RESPONDER ANALYSIS OF RITLECITINIB VERSUS BARICITINIB IN SEVERE ALOPECIA AREATA: A SPANISH HEALTHCARE PERSPECTIVE
Author(s)
ALFONSO DE LOSSADA JUSTE, PharmD1, Irene Hernández-Martín, PhD1, Ashley S. Cha-Silva, MS, PharmD2, Ernest H. Law, PharmD, PhD3, Ana Calvo, MSc4, NEUS VIDAL VILAR, MSc4.
1Pfizer SLU, Madrid, Spain, 2Pfizer Inc., Trumbull, CT, USA, 3Pfizer, New York, NY, USA, 4Outcomes’10 (a ProductLife Group Company), CASTELLON, Spain.
1Pfizer SLU, Madrid, Spain, 2Pfizer Inc., Trumbull, CT, USA, 3Pfizer, New York, NY, USA, 4Outcomes’10 (a ProductLife Group Company), CASTELLON, Spain.
OBJECTIVES: Severe alopecia areata (AA) is a chronic immune-mediated disease associated with substantial burden. With several treatment options available, comparative economic evidence is increasingly relevant. This analysis estimated the 1-year cost-per-responder (CPR) of ritlecitinib versus baricitinib in severe AA patients in Spain.
METHODS: A decision-tree model was adapted to estimate a base case 1-year CPR of once-daily ritlecitinib 50 mg and baricitinib 4 mg in severe AA patients from the Spanish National Health System perspective. Drug acquisition costs were sourced from BotPlus (€2026) and estimated up to Week 52. Short-term response was defined as ≥30% improvement from baseline in Severity of Alopecia Tool (SALT) score at Week 24, and long-term response as SALT ≤20 at Week 52; non-responders were assumed to discontinue treatment. Efficacy inputs were derived from ALLEGRO-2b/3 (NCT03732807) and BRAVE-AA1/BRAVE-AA2 (NCT03570749; NCT03899259) trials, assuming equivalence between Week 48 and Week 52 outcomes for ritlecitinib. Scenario analyses evaluated alternative baricitinib dosing (2 mg/4 mg with Week 18 up-titration) and price discounts using a two-dimensional matrix.
RESULTS: In the base case analysis, ritlecitinib 50 mg showed higher response rates than baricitinib 4 mg at Week 24 (52.1% vs 46.8%) and at Week 52 (40.3% vs 30.6%), respectively. Week 52 drug costs were €7,282 for ritlecitinib 50 mg and €6,692 for baricitinib 4 mg, resulting in a lower CPR for ritlecitinib 50 mg (€18,088 vs €21,852; −€3,764). Results remained favorable to ritlecitinib under alternative baricitinib 2 mg/4 mg dose distributions, with a CPR difference of −€2,189. In the discount matrix, baricitinib became economically favorable only when its discount exceeded ritlecitinib’s discount by 15 percentage points.
CONCLUSIONS: Ritlecitinib 50 mg was associated with lower Week 52 CPR than baricitinib. These findings suggest that ritlecitinib may offer better economic value versus baricitinib in severe AA patients and support evidence-based decision-making in the Spanish setting.
METHODS: A decision-tree model was adapted to estimate a base case 1-year CPR of once-daily ritlecitinib 50 mg and baricitinib 4 mg in severe AA patients from the Spanish National Health System perspective. Drug acquisition costs were sourced from BotPlus (€2026) and estimated up to Week 52. Short-term response was defined as ≥30% improvement from baseline in Severity of Alopecia Tool (SALT) score at Week 24, and long-term response as SALT ≤20 at Week 52; non-responders were assumed to discontinue treatment. Efficacy inputs were derived from ALLEGRO-2b/3 (NCT03732807) and BRAVE-AA1/BRAVE-AA2 (NCT03570749; NCT03899259) trials, assuming equivalence between Week 48 and Week 52 outcomes for ritlecitinib. Scenario analyses evaluated alternative baricitinib dosing (2 mg/4 mg with Week 18 up-titration) and price discounts using a two-dimensional matrix.
RESULTS: In the base case analysis, ritlecitinib 50 mg showed higher response rates than baricitinib 4 mg at Week 24 (52.1% vs 46.8%) and at Week 52 (40.3% vs 30.6%), respectively. Week 52 drug costs were €7,282 for ritlecitinib 50 mg and €6,692 for baricitinib 4 mg, resulting in a lower CPR for ritlecitinib 50 mg (€18,088 vs €21,852; −€3,764). Results remained favorable to ritlecitinib under alternative baricitinib 2 mg/4 mg dose distributions, with a CPR difference of −€2,189. In the discount matrix, baricitinib became economically favorable only when its discount exceeded ritlecitinib’s discount by 15 percentage points.
CONCLUSIONS: Ritlecitinib 50 mg was associated with lower Week 52 CPR than baricitinib. These findings suggest that ritlecitinib may offer better economic value versus baricitinib in severe AA patients and support evidence-based decision-making in the Spanish setting.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE732
Topic
Clinical Outcomes, Economic Evaluation, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)