OBJECTIVES: The objective of this analysis was to compare the cost per responder based on the Assessment of Spondyloarthritis International Society (ASAS) outcomes at 24 weeks of treatment of ankylosing spondylitis (AS) with secukinumab relative to adalimumab and golimumab from a third payer perspective.

METHODS: The cost per responder for each treatment was estimated by dividing the drug acquisition cost with its response rate. Drug costs were estimated in US dollars (USD) from public sources: DIGEMID and SEACE for private and public health schemes, respectively. Response rates were used from a previous matching-adjusted indirect comparison (MAIC) based on the data from MEASURE1-2, ATLAS and GO-RAISE clinical trials of secukinumab, adalimumab and golimumab, respectively. MAIC analysis matched several patient characteristic such as age, gender distribution, Bath Ankylosing Spondylitis Functional Index (BASFI), C-reactive protein (CRP) and TNF-naive proportion at the baseline.

RESULTS: Response rates were significantly higher for secukinumab compared to adalimumab and golimumab at 24 weeks in the MAIC. Private health scheme costs per ASAS20 responder were USD12.259 vs USD30.004, cost per ASAS40 responder were USD14.616 vs USD38.420, costs per ASAS5/6 responder were USD28.519 vs USD68.488 for secukinumab vs adalimumab, respectively. For secukinumab versus golimumab, costs per ASAS20 responder were USD11.923 vs USD18.677, cost per ASAS40 responder were USD14.362 vs USD23.658, whereas, costs per ASAS5/6 responder were USD26.153 vs USD40.556, respectively. Additional analysis for Public health scheme present similar results for both comparisons. Sensitivity analyses for ASAS response rates and cost per responder showed similar results, confirming the validity of the main analysis.

CONCLUSIONS: The cost per responder for all ASAS outcomes were consistently lower for secukinumab versus all comparators, showing the dominance of secukinumab versus adalimumab and golimumab. These findings indicate that it is more efficient to treat AS patients with secukinumab versus adalimumab and golimumab in the Peruvian context.