OBJECTIVES: To assess the cost-effectiveness of N-acetyl-GED-0507-34-LEVO (NAC-GED 5%) versus benzoyl peroxide plus adapalene for moderate-to-severe acne vulgaris from the perspective of the UK's National Healthcare Services (NHS).

METHODS: A decision-analytic model was developed based on a previous cost-effectiveness analysis (CEA) by Mavranezouli et al. (2022) that informed the National Institute for Health and Care Excellence (NICE) Guidelines for acne management. The model considered a 1-year time-horizon and evaluated the incremental cost-effectiveness of NAC-GED 5% compared to benzoyl peroxide (BPO) plus adapalene and other available treatments in patients aged 9 years and above. Expert interviews validated the model’s inputs, assumptions, and results. An economically justifiable price for NAC-GED 5% was determined for a willingness-to-pay (WTP) threshold of £20,000 per quality-adjusted life year (QALY).

RESULTS: At a WTP threshold of £20,000/QALY, the economically justifiable price of NAC-GED 5% was £59.42 per 35g tube compared to BPO plus adapalene. The model’s results were robust in sensitivity analyses, with NAC-GED 5% efficacy and BPO plus adapalene discontinuation rates were identified as key drivers of the incremental cost-effectiveness ratio. Furthermore, NAC-GED 5% demonstrated comparable efficacy to oral isotretinoin (<120 mg/kg) with a similar cost, the shorter onset of action, and lower discontinuation rates.

DISCUSSION: This study is the first early cost-effectiveness analysis in the acne space, examining the relative cost-effectiveness of NAC-GED 5% based on Phase II trial results across a range of treatment options for moderate-to-severe acne vulgaris. Future analyses should incorporate safety and efficacy data from Phase III trials or perform indirect treatment comparisons if head-to-head data is unavailable and develop a comprehensive cost-effectiveness model. Additionally, capturing patient-reported outcomes to demonstrate improvements in quality of life is necessary.

CONCLUSIONS: NAC-GED 5% showed favorable results in acne improvement and cost-effectiveness, with lower discontinuation rates and good efficacy.