OBJECTIVES: Clinicians can choose between several systemic treatments for patients with moderate-to-severe atopic dermatitis (AD) who are not adequately controlled with topical therapies and/or phototherapy. These treatments include the biologic therapies tralokinumab and dupilumab. However, no head-to-head trials have been conducted between these two biologic treatments. The objective was to estimate the cost-per-responder for tralokinumab and dupilumab in combination with topical corticosteroids (TCS) as treatments for moderate-to-severe AD based on an indirect comparison of efficacy.

METHODS: A cost-per-responder model was constructed to estimate the average cost per AD patient who achieved a clinically significant response using a biologic treatment in combination with TCS. Treatment efficacy evidence (32-week EASI-75 and IGA 0/1 response rates) from an unanchored matching-adjusted indirect comparison (MAIC) using patient-level data from ECZTRA-3 (tralokinumab) and aggregate data from LIBERTY AD CHRONOS (dupilumab) was used. The model included treatment costs based on list prices of the United Kingdom, Italy, Germany, France, and Spain. Treatment cost was defined as drug cost over a 32-week time horizon. The cost-per-responder was calculated for each comparator by multiplying the treatment cost by the number needed to treat (NNT).

RESULTS: Based on EASI-75 response criteria, cost-per-responder estimates ranged between €16,582 and €34,004 for tralokinumab and between €21,609 and €35,794 for dupilumab. Based on IGA 0/1 response criteria, cost-per-responder estimates ranged between €21,792 and €44,688 for tralokinumab and between €40,127 and €66,469 for dupilumab. In all cases, across all countries, cost-per-responder estimates for tralokinumab were lower or equal to dupilumab.

CONCLUSIONS: This analysis indicates that using tralokinumab for moderate-to-severe AD patients generally results in lower cost-per-responder estimates compared to dupilumab, considering evidence from an indirect comparison of treatment efficacy and medication costs over a 32-week time horizon.