A COST PER RESPONDER ANALYSIS OF SECUKINUMAB VS. ADALIMUMAB BASED ON A MATCHING-ADJUSTED INDIRECT COMPARISON OF EFFICACY DATA FOR THE TREATMENT OF ANKYLOSING SPONDYLITIS AT 52 WEEKS FROM THE IRISH PAYER PERSPECTIVE

Author(s)

Gunda P1, Nikoglou E2, Jugl SM3, Murphy A4
1Novartis Healthcare Private Limited, Hyderabad, India, 2Product Lifecycle Services - NBS, Novartis Global Service Center Dublin, Dublin, Ireland, 3Novartis Pharma AG, Basel, Switzerland, 4Novartis Ireland Ltd, Dublin, Ireland

OBJECTIVES: The objective of this analysis was to estimate and compare the long-term cost per responder (CPR) in Ireland based on the Assessment of Spondyloarthritis International Society (ASAS) outcomes following 52 weeks of treatment for ankylosing spondylitis (AS) with the fully human anti-IL-17A antibody Secukinumab 150mg (SEC) relative to the anti-TNF antibody Adalimumab (ADA).

METHODS: CPR for each treatment was calculated by dividing the drug acquisition cost for the course of treatment with the corresponding response rates from a previously reported matching-adjusted indirect comparison (MAIC) based on MEASURE 2 and ATLAS RCTs. Drug costs were estimated based on cost to the national Irish payer (including VAT, rebates and wholesaler margins) and the number of doses required for 52 weeks. Other cost domains like administration or high-tech patient care fees were not included as this was considered to be equal for both treatments.

RESULTS: Previous MAIC analysis showed that ASAS 20/40 response rates, which are key outcomes to determine symptomatic improvement in AS, were higher for SEC vs. ADA. ASAS 20/40 response rates were 81% and 65%; and 62% and 47% for SEC and ADA, respectively. CPR for ASAS 20/40 were EUR 13,856 and EUR 25,793; and EUR 18,013 and EUR 35,861 for SEC and ADA, respectively. SEC dominated ADA in terms of CPR, as the response rates were higher and the overall drug acquisition cost for 52 weeks was lower for SEC as compared to ADA. Sensitivity analyses confirmed the robustness of the main analysis. Results were based on list-prices as of May 2017.

CONCLUSIONS: The 52 weeks CPR for ASAS 20/40 response rates were lower for SEC compared to ADA in AS patients. Furthermore, with higher outcomes at lower costs, these findings suggest dominance of SEC over ADA. More AS patients could be treated more effectively with SEC versus ADA in Ireland.

Conference/Value in Health Info

2017-11, ISPOR Europe 2017, Glasgow, Scotland

Value in Health, Vol. 20, No. 9 (October 2017)

Code

PMS38

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Musculoskeletal Disorders

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