BACKGROUND: Psoriasis is a chronic, noncommunicable disease that has a great negative impact on patients’ quality of life. Moderate-to-severe disease occurs in approximately 30% оf patients, and biologics are the main treatment option in this case. Elevated biologic treatment expenses can become a significant socioeconomic burden for both individuals and the overall health-care system. Cost-effectiveness analysis helps to determine optimal biologic treatment options that fall within the cost-effectiveness threshold.

OBJECTIVES: The aim of the study was to systematically review the current literature on the cost-effectiveness analysis (CEA) of existing biologics for the treatment of moderate-to-severe psoriasis, assess the articles’ quality, and summarize the main characteristics of the models, inputs and results.

METHODS: We used specific search strategies and filters to analyze publications in Pubmed, Cochrane library, e-library and Google Scholar. Only studies in English and Russian were included into analysis. All references within the relevant review articles were examined manually. To evaluate the quality of articles, we used Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Checklist and the Quality of Health Economic Studies (QHES) instruments. Main study attributes such as the type of economic model, assumptions, effectiveness outcomes, cost measures, time horizon, and perspective, were summarized and presented in tables.

RESULTS: Overall, twenty-two articles were included in the final review: ten of them (45%) utilized empirical economic evaluations over 12 to 54 weeks period; eight articles (36%) used Markov models with timeline from 3 years to life span. Most of these studies originated from the United States (27%) and the UK (18%). The most popular biologic agents used in the cost-effectiveness analyses were adalimumab, infliximab, ustekinumab, and etanercept. Treatment sequences with adalimumab and ustekinumab were the most cost-effective.

CONCLUSIONS: This study provides an overview of the main characteristics of the cost-effectiveness analyses of biologic agents used to treat moderate-to-severe psoriasis.