OBJECTIVES: To analyze the cost-effectiveness (CE) of secukinumab compared to adalimumab in Spain in terms of cost per responder (CPR) for the treatment of Hidradenitis Suppurativa (HS).

METHODS: Cost-effectiveness analysis based on a decision tree, considering efficacy, posology and pharmacological costs associated with both secukinumab and adalimumab treatments. The efficacy data used in the analysis is derived from clinical trials for both drugs. For the lack of data for adalimumab, a conservative approach has been adopted, applying the long-term data for secukinumab. The PVLs for secukinumab and an average acquisition price for adalimumab and biosimilars in Spain (2020-2022) have been used. Several price sensitivity analyses were performed. Treatment sequences were considered according to the technical data sheet and clinical consensus. Time horizon 1 and 2 years.

RESULTS: Initiating HS treatment with secukinumab is more efficient than adalimumab, both in terms of total number of patients who respond positively and the pharmacological CPR. Even with a significant reduction of the price of adalimumab, the lower CPR observed with secukinumab remains consistent.

CONCLUSIONS: The sustained efficacy of secukinumab leads to a larger number of patients achieving disease control and lower CPR when compared to adalimumab. Furthermore, the economic impact of primary failure with adalimumab is significant. Results demonstrate that secukinumab is an efficient therapeutic alternative, which provides a new mechanism of action and better posology for the treatment of HS in Spain.