OBJECTIVES: Anti-interleukin (IL) therapies have emerged as a major group of treatment for autoimmune diseases. In a head-to-head phase 3 trial, guselkumab (GUS) demonstrated superior long-term response through Week 48 compared to secukinumab (SEC) in patients with moderate to severe psoriasis (PsO). We sought to compare the cost per responder of these two therapies in the management of moderate to severe PsO from the perspective of the Brazilian private healthcare system.

METHODS: Costs per responder for GUS and SEC were compared in the 1^st year (induction phase) and 2^nd+ years (maintenance phase). Costs drug acquisition (following drug label dosage) and were retrieved from the Brazilian official price list. The efficacy analysis was based on the ECLIPSE trial, for which the primary endpoint was PASI 90 response at week 48. Efficacy data only through week 48 are available, and it was assumed that PASI 90 responses were the same for both the induction and maintenance treatment phases. The cost per responder was calculated by dividing the annual costs for each drug by the proportion of patients achieving a PASI 90 response.

RESULTS: Overall treatment costs for the two years assessed in the model was BRL 31,113 lower in the GUS arm. The cost per responder result was lower for GUS compared with SEC in both induction and maintenance phases. The cost per PASI 90 response for the induction phase was BRL 101,783 vs. BRL 147,390 and for maintenance phase BRL 82,699 vs. BRL 119,754 for GUS and SEC, respectively.

CONCLUSIONS: Based on the perspective of Brazilian private healthcare system, GUS demonstrated lower costs per responder compared with SEC for the treatment of moderate to severe PsO.