OBJECTIVES: Psoriatic arthritis (PsA) is associated with serious activity and work productivity impairment. For the first time in this disease area, this study estimates to what extent a novel medication, secukinumab, can reduce these societal and economic effects.

METHODS: A Markov and a population model based on German PsA patients were used to simulate the progression of PsA under secukinumab versus the non-bioligic standard of care (methotrexate, sulfasalazine, leflunomide). Disease severity was measured via the Health Assessment Questionnaire-Disability Index (HAQ-DI) for the population of PsA patients predicted to receive secukinumab from 2017 to 2030, accounting for treatment discontinuation and disease progression. The relationship between HAQ-DI and the Work Productivity and Impairment Questionnaire in PsA patients was employed to determine the relative productivity benefit through the usage of secukinumab. Time-use survey and estimates of PsA-specific employment data were utilized to calculate the total amount of productive and active time gained, which will potentially be used for paid and unpaid work activities. Paid work was valued according to industry specific wages and unpaid work was valued according to the proxy good approach. Further economic effects induced by productivity increases were also taken into account.

RESULTS: The usage of secukinumab decreases work and productivity impairment in the target population by over 13 percentage points, compared to the non-biologic standard of care, generating 30.6 million active and productive hours until 2030. These correspond to gross value added effects in the German economy of EUR 2.64 billion.

CONCLUSIONS: This study shows that the usage of biologics like secukinumab could lead to substantial reductions of functional limitations associated with PsA compared to the non-biologic standard of care, corresponding to significant societal and economic effects. In addition, the importance of including unpaid work in calculating the societal impact of a medication was demonstrated.