Author(s)
Colombo D1, Fiocchi M1, Ori A2, Simoni L2, Bianchi L3, Fabbrocini G4, Corrao S5, Offidani A6, Stingeni L7, Costanzo A8, Pellacani G9, Peris K10, Bardazzi F11, Argenziano G12, Ruffolo S13, Dapavo P14, Carrera C15, Fargnoli MC16, Parodi A17, Romanelli M18, Malagoli P19, Zagni E1
1Novartis Farma S.p.A., Origgio, Italy, 2MediNeos Observational Research - IQVIA, Modena, Italy, 3Policlinico Tor Vergata, Rome, Italy, 4A.O.U. Federico II, Naples, Italy, 5ARNAS Civico, Palermo, Italy, 6A.O.U. Riuniti Umberto I Lancisi Salesi, Ancona, Italy, 7University of Perugia, Perugia, Italy, 8Humanitas Clinical and Research Center – IRCCS, Milan, Italy, 9A.O.U. Policlinico, Modena, Italy, 10Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy, 11A.O.U. Policlinico S.Orsola-Malpighi, Bologna, Italy, 12Policlinico Luigi Vanvitelli, Naples, Italy, 13A.O. Cosenza Ospedale SS Annunziata, Cosenza, Italy, 14A.O.U. Città della Salute e della Scienza PO Molinette, Turin, Italy, 15Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy, 16University of L'Aquila, L'Aquila, Italy, 17Ospedale Policlinico San Martino, Genova, Italy, 18A.O.U. Pisana Ospedale Santa Chiara, Pisa, Italy, 19Policlinico San Donato, San Donato Milanese (MI), Italy
OBJECTIVES: To estimate the cost per responder of biologics for plaque psoriasis in Italy based on the CANOVA study. METHODS: CANOVA was an observational (retrospective and prospective) cohort study conducted in 17 Italian dermatology clinics, including adult patients with moderate-severe plaque psoriasis, who had started a biologic treatment in a retrospective period between 24 and 6 months before enrollment. Patients were observed from the start of the most recent retrospective biologic (baseline) until a 6-month visit after enrollment. Data on resource consumption (biologic and non-biologic drugs, inpatient and outpatient care) and response ( achievement of 75%/90%/100% improvement in baseline PASI-Psoriasis Area and Severity Index) were collected at 16/24/52 weeks from baseline. Cost per responder was calculated as direct costs (retrieved from national databases) divided by number of responders. Descriptive analyses were performed on the overall sample and stratified by the currently most-frequently prescribed biologics (i.e. adalimumab originator; ixekizumab; secukinumab; ustekinumab). RESULTS: Among 669 eligible patients, median annualized cost was €14,699 (interquartile range: €13,785 - €15,779), with biologics being the driver of expenditure. Costs per PASI-75, PASI-90 and PASI-100 responder at 52 weeks were €20,281 (N=551; response rate: 91%), €24,662 (N=540; 75%) and €35,045 (N=564; 53%), respectively. Cost per responder (considering PASI-90) at 52 weeks varied by treatment group, with lowest values in adalimumab (€22,755; N=62) and secukinumab (€23,978; N=238) and highest values in ixekizumab (€24,743; N=63) and ustekinumab (€27,522; N=140). The lowest cost per sustained response, i.e. achievement of at least PASI-75 response both at 16 and at 52 weeks, was observed for secukinumab (€21,375; N=169; response rate: 86%). CONCLUSIONS: Cost-effectiveness profile of biologics was positive (because of high response) with some trends in favour of adalimumab and secukinumab. Besides patient preferences and comorbidities, cost per response is useful to guide treatment decisions.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PSS3
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Biologics and Biosimilars, Sensory System Disorders