OBJECTIVES:

To estimate the budget impact of upadacitinib 15 and 30 mg for treating adults and adolescent patients with moderate-to-severe atopic dermatitis (AD) and inadequate response to topical and non-targeted systemic immunosuppressive therapies, for social security and private third-party payers in Argentina.

METHODS:

A budget impact analysis was estimated using the respective third-party payer over five years. A hypothetical cohort of 1,000,000 covered subjects was modeled. Input parameters were obtained from a literature review complemented by expert opinion using the modified Delphi method. The model estimated the target population using AD prevalence, incidence, diagnosis rate, and treatment rate (percentage of candidate population and with optimal access to targeted immunomodulatory drugs). Healthcare costs parameters were estimated using the micro-costing approach and expressed in US dollars (USD) as of August 2021 (exchange rate 1 USD = 97.74 ARS). A one-way sensitivity analysis was conducted.

RESULTS: The net budget impact over 5-years in the moderate-to-severe AD population was -$335,710 USD (year 1) and -$3,681,014 USD (year 5), from the social security perspective. For the private sector, the net budget impact was -$347,417 USD (year 1) and -$3,810,134 USD (year 5). The incorporation of upadacitinib for the treatment of moderate-to-severe AD was associated with net savings concerning acquisition and drug administration costs and a marginal net increase in adverse event costs. The three most influential parameters for the budget impact were the treatment rate, the price of upadacitinib 30mg, and the disease prevalence.

CONCLUSIONS:

The incorporation of upadacitinib 15mg and 30mg for moderate-to-severe AD with an inadequate response to topical and non-targeted systemic immunosuppressive therapies was associated with net savings for social security and private third-party payers in Argentina. These findings are informative to support policy decisions aimed to expand the current treatment landscape of AD.