OBJECTIVES: Secukinumab is the first fully human monoclonal antibody that selectively neutralizes IL-17A, which is approved for the treatment of Ankylosing Spondylitis (AS). In the context of no head to head trial comparing secukinumab 150mg (SEC150) with other biological agents listed by the Brazilian Unified Health System (SUS) for the treatment of AS (adalimumab, etanercept, infliximab and golimumab), we conducted a cost-minimization analysis (CMA) to compare the costs generated by the use of SEC150 compared to other biologics in AS.

METHODS: As for any CMA, it was assumed that the efficacy of SEC150 was comparable to those of the comparators. Annual treatment costs per patient in the first and second year of treatment were calculated in order to capture the difference in costs of induction and maintenance treatment phases between treatments. Only drug costs were considered, which were estimated using the latest public price for government purchases and the number of doses required for 48 weeks, according to the SUS AS Clinical Guideline. To evaluate the robustness of the analysis, one-way sensitivity analyses (OWSA) were performed.

RESULTS: SEC150 had the lowest annual drug costs in both first and second year of treatment (BRL 9,895.20 and BRL 7,916.16, respectively). The difference on the annual drug costs of SEC150 versus other biologics ranged from -BRL 5,428.56 to -BRL 18,967.20 in the first year and from -BRL 7,407.60 to -BRL 13,730.64 in the second year. Based on the maintenance treatment phase (from second year on), the savings generated per patient per year ranged from 48% (vs. golimumab) to 63% (vs. infliximab). The OWSA confirmed the favorable results for SEC150 in all scenarios evaluated.

CONCLUSIONS: SEC150 is a cost-saving alternative when compared to other biologic agents already reimbursed by SUS for the treatment of AS in Brazil.