OBJECTIVES: Biological therapies have been a breakthrough in the treatment of plaque psoriasis (PsO), but wide variations exist in patient response. Guselkumab (GUS) has been shown in 2 head-to-head phase 3 trials to be superior to adalimumab (ADA) for the treatment of moderate to severe PsO. This study aims to estimate the cost per responder of GUS compared to ADA in moderate to severe PsO patients from the Brazilian private healthcare system perspective.

METHODS: This cost per responder analysis used drug acquisition costs and PASI 90 response rates to compare GUS and ADA. Drug costs were obtained from the official price list. The annual cost was calculated using the dosage described in each of the drugs labels. Week 48 PASI 90 response rates for both treatments were derived from the VOYAGE 1 trial. The cost per responder was calculated by dividing the total annual costs for both induction (1^st treatment year) and maintenance phases (2^nd+ treatment years) by the proportion of patients achieving a PASI 90 response, assuming the same responses for both treatment phases.

RESULTS: GUS showed lower overall treatment costs of BRL 47,736 in the induction and maintenance phases compared to ADA. Cost per PASI 90 responder in the induction phase (1^st year) was BRL 112,722 for GUS vs. BRL 216,561 for ADA. For the maintenance phase (2^nd+ year) the cost per PASI 90 responder was BRL 91,587 for GUS vs. 208,540 for ADA.

CONCLUSIONS: From the perspective of the Brazilian healthcare system, GUS achieved lower costs per PASI 90 responder compared to ADA for the treatment of moderate to severe PSO.