OBJECTIVES: To estimate the incremental cost of introducing abrocitinib, an oral, selective JAK1 inhibitor, with faster onset on efficacy compared to dupilumab for the treatment of moderate to severe atopic dermatitis in Denmark. The efficacy and safety of both abrocitinib and dupilumab has been investigated in the head-to-head trial, JADE DARE (Reich et al. 2022).

METHODS: A cost-minimization analysis was performed to calculate the incremental costs per patient of treatment with abrocitinib compared to treatment with dupilumab. A limited societal perspective was applied, and costs included in the model were those expected to differ for the two treatment options, including drug acquisition costs, administration costs, resource use and patient costs. Costs related to treatment of adverse events were included to incorporate the differences in the safety profiles between abrocitinib and dupilumab. A micro-based cost approach was used to estimate hospital costs, including hourly costs for practitioners and examination rooms. In the base case analysis, the model has a time horizon of 52 weeks.

RESULTS: The total costs per patient, including patient costs, of treatment with abrocitinib were DKK 89,497, while the total costs per patient including patient costs of treatment with dupilumab were DKK 115,639, which gives an incremental cost of DKK -26,142. Excluding patient costs, gives an incremental cost of DKK -26,790 for treatment with abrocitinib compared to dupilumab. The incremental costs of treatment with abrocitinib compared to dupilumab are primarily driven by drug costs, as 98% of the total costs are drug costs.

CONCLUSIONS: Given that abrocitinib has similar clinical efficacy compared with dupilumab, is a highly cost-saving alternative to dupilumab, and has a flexible oral administration, abrocitinib is an attractive treatment option for both patients, hospitals, and the healthcare sector in general.