OBJECTIVES: This analysis aimed to estimate the cost per responder in the United Kingdom (UK) of two innovative treatments, guselkumab and secukinumab, leveraging treatment cost data and head-to-head efficacy results from the Phase 3 ECLIPSE clinical trial.

METHODS: A cost per responder model was developed using efficacy data from ECLIPSE to inform treatment response. Treatment response definitions included: achievement of 90% improvement in baseline Psoriasis Area and Severity Index (PASI) score (ie, PASI 90 response), PASI 100 response, or an Investigator’s Global Assessment (IGA) score of 0/1 (cleared/minimal). Only drug costs were considered, based on European Medicines Agency Summary of Product Characteristics dosing and 2019 UK list prices as published in the British National Formulary. The analyses were conducted at Week 48 (PASI 90 response, PASI 100 response, and IGA score 0/1) and from Week 12 to 48 (PASI 90).

RESULTS: At Week 48, guselkumab was associated with a significantly higher PASI 90 response rate (84.5% vs. 70.0%, p<0.001) and lower overall drug costs (£15,750 vs. £17,063) than secukinumab, leading to a lower cost per PASI 90 responder (£18,639 vs. £24,376). Similarly, guselkumab had lower costs per PASI 100 and IGA 0/1 responder at Week 48 (£27,062 vs. £35,254 and £18,529 vs. £22,781, respectively). Additionally, guselkumab had a lower cost per PASI 90 responder at all timepoints assessed from Week 12 to Week 48.

CONCLUSIONS: Based on data from the ECLIPSE trial, guselkumab had a lower cost per responder than secukinumab across all responder definitions and timepoints evaluated. The use of guselkumab in place of secukinumab could result in cost savings of £4,252 to £8,192 per responder after 48 weeks of treatment. These results suggest that guselkumab offers greater economic value than secukinumab in the treatment of moderate to severe plaque psoriasis through approximately one year of treatment.