OBJECTIVES: Advances in biologic drugs used to treat moderate-to-severe plaque psoriasis have greatly improved the outcomes for patients suffering from the disease. The objective of this study was to estimate the cost-per-responder of anti-IL17 drugs and other biologics used in the treatment of moderate-to-severe plaque psoriasis in France and Germany over a one-year time-horizon.

METHODS: A cost-per-responder model of biologics used in psoriasis treatment was developed based on both induction and maintenance treatment periods. Anti-TNFs (adalimumab, etanercept), anti-IL17s (brodalumab, secukinumab, ixekizumab and bimekizumab), anti-IL12/23 (ustekinumab) and anti-IL23s (risankizumab and guselkumab) were included in the model. Efficacy data were identified through a systematic literature review of network meta-analyses that informed on various long-term Psoriasis Area and Severity Index (PASI) measures. The cost of drugs was based on dose recommendations as well as the pharmacy list prices in France and manufacturer prices in Germany. When biosimilar substitution was possible, the cheapest alternative was used.

RESULTS: Among the anti-IL17s, brodalumab had the lowest cost-per-PASI100 responder in both France (€21,679) and Germany (€26,807) after one year, followed by bimekizumab (€26,369) in France and ixekizumab (€38,027) in Germany. Brodalumab also had the lowest cost-per-PASI90 responder among the anti-IL17s in both France and Germany after one year. Adalimumab had the lowest cost-per-PASI100 responder after one year among the anti-TNFs in both France (€23,418) and Germany (€38,264). Among the anti-IL23s, the lowest cost-per-PASI100 responder after one year was risankizumab (€20,969) in France and guselkumab (€28,902) in Germany. The cost-per-PASI100 responder for ustekinumab after one year was (€35,666) in France and (€72,078) in Germany. All results remained consistent over a three-year time horizon.

CONCLUSIONS: Over a one-year time-horizon, risankizumab and brodalumab were the most cost-effective biologics in France and Germany within moderate-to-severe plaque psoriasis. Brodalumab was most cost-effective within the anti-IL17s, including the newly launched bimekizumab.