COST-EFFECTIVENESS ANALYSIS OF SECUKINUMAB COMPARED TO CURRENT BIOLOGICS SEQUENCES FOR THE TREATMENT OF MODERATE TO SEVERE PLAQUE PSORIASIS IN FRANCE
Author(s)
Duteil E1, Cariou C1, Schmidt A2, Benjamin K1, Duco J1
1Novartis Pharma, Rueil-Malmaison, France, 2st[è]ve consultants, Oullins, France
OBJECTIVES: To estimate the cost-effectiveness of treatment sequences including secukinumab in first line versus the most commonly used treatment sequences in clinical practice for the treatment of moderate to severe plaque psoriasis (PP) from a French collective perspective. METHODS: The model combined a decision tree for the first year and a markov state transition model for the 9 subsequent years. The two treatment phases (i.e. induction and maintenance phases) of biologics were taken into account into this combined model. The model included four health states based on the Psoriasis Area Severity Index (PASI) score and one absorbent state (death). Ten biotherapies sequences, of which 4 included secukinumab were compared in the model: secukinumab-adalimumab (SEC-ADA), secukinumab-etanercept (SEC-ETN), ustekinumab-adalimumab (UST-ADA), secukinumab-infliximab (SEC-INF), secukinumab-ustekinumab (SEC-UST), adalimumab-etanercept (ADA-ETN), adalimumab-ustekinumab (ADA-UST), adalimumab-infliximab (ADA-INF), etanercept-adalimumab (ETN-ADA) and etanercept-ustekinumab (ETN-UST). Comparative efficacy data were derived from a network meta-analysis for secukinumab and biologic comparators. The EQ-5D data from the ERASURE, FIXTURE, SCULPTURE, STATURE, FEATURE and JUNCTURE secukinumab trials were converted into utility value using French tariffs. Health care consumption was estimated from French clinical experts’ recommendations and the summary of product characteristics, and valued using French databases. Costs were expressed in euros (€, 2015) and a 4% annual discount rate was applied to both costs and health measures. Results were analyzed with the recommended efficiency frontier approach and tested in multiple sensitivity analyses. RESULTS: The efficiency frontier was delimited by 4 sequences: UST-ADA, SEC-ADA, SEC-ETN and SEC-INF and the corresponding ICER were: 45,902 €/QALY, 47,083 €/QALY and 426,000 €/QALY for SEC-ADA compared to UST-ADA, SEC-ETN compared to SEC-ADA and SEC-INF compared to SEC-ETN respectively. CONCLUSIONS: Treatment sequences with secukinumab are efficient alternatives to current biologics sequences, in the French setting. The sensitivity analyses confirmed the robustness of the results.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PSY80
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Sensory System Disorders