OBJECTIVES: To assess the cost-effectiveness of secukinumab versus current therapies for plaque psoriasis in adults from the Canadian healthcare perspective. METHODS: A Markov model was designed to determine the cost-effectiveness of secukinumab 300mg for moderate to severe plaque psoriasis over a 10-year horizon versus secukinumab 150mg, adalimumab, etanercept, infliximab, ustekinumab (45mg or 90mg), and standard of care (oral systemics, topicals, and phototherapy, SoC). Year 1 of the model consisted of 4-week cycles with 4 Psoriasis Area and Severity Index (PASI) response level-based health-states (PASI ≥ 90, 75-89, 50-74, and < 50). Years 2-10 used annual cycles, with 3 health-states (PASI ≥ 75, PASI <75, and death).  Decisions to switch to SoC were made at week 12 and 52, then annually. Efficacy data from a network meta-analysis informed first-year model transitions. Resource use, costs, and utilities were collected from clinical trials, published literature, expert opinion, and standard Canadian sources. RESULTS: The order of treatments by increasing quality-adjusted life years (QALYs) were: SoC, etanercept,  adalimumab, ustekinumab 45mg, secukinumab 150mg, ustekinumab 90mg, secukinumab 300mg, and infliximab. The cost-effectiveness frontier showed etanercept was strongly dominated, while adalimumab, ustekinumab 45mg, secukinumab 150mg and ustekinumab 90mg were weakly dominated by secukinumab 300mg. The ICER for secukinumab 300mg versus SoC was $87,368/QALY gained. The ICER for infliximab versus secukinumab 300mg was $1,039,403/QALY gained. Deterministic sensitivity analyses indicated the results are most sensitive to time horizon, cost of biologics, and utility values. The probabilistic sensitivity analysis demonstrated that at a willingness-to-pay threshold of ~$90,000/QALY, secukinumab 300mg has the highest probability of being the cost-effective option.  CONCLUSIONS: For adults with moderate to severe plaque psoriasis, secukinumab 300mg was associated with increased QALYs at a lower incremental cost compared to etanercept, adalimumab, ustekinumab and secukinumab 150mg. For each QALY gained versus SoC, treatment with secukinumab costed an additional $87,368.