OBJECTIVES

: Secukinumab (SEC) 300 mg, a fully human interleukin-17A antibody, demonstrated sustained superior efficacy over ustekinumab (UST) 45/90 mg, an anti-interleukin-12/23 antibody, through 52 weeks in adults with moderate-to-severe psoriasis, in CLEAR head-to-head study comparing SEC to UST. This analysis compared the cost per responder of SEC versus UST over 1 year, from a Saudi payer perspective.

METHODS

: A 52-week decision-tree model, reflecting treatment response defined as Psoriasis Area Severity Index (PASI) reduction of ≥75%, ≥90% and 100%, evaluated cost per responder (PASI75, PASI90 and PASI100). Responders at week 16 continued the initial treatment. Non-responders and drop-outs were switched to standard of care. Analyses were conducted for responders over 16 weeks and 52 weeks, as well as for sustained responders between weeks 16 and 52. Total costs in the analysis included drug costs and resource costs, obtained from the Saudi Food and Drug Authority website and national sources respectively, for 2018. No discount was applied.

RESULTS

: Estimated cost per PASI100 responder was lower for SEC compared to UST over 16 weeks (SEC: SAR100,265; UST: SAR114,495), 52 weeks (SEC: SAR226,589; UST: SAR328,290), and for 52-week sustained response (SEC: SAR113,082; UST: SAR126,504). Overall, costs per PASI75 and PASI90 responders were also lower for SEC than for UST. Time spent in PASI90-99 and PASI100 was longer in SEC than in UST (0.31 vs 0.24 years and 0.40 vs 0.20 years, respectively). Sensitivity analysis also confirmed the robustness of results: cost per PASI responders remained lower for SEC than for UST.

CONCLUSIONS

: The cost per responder over 1 year in Saudi Arabia in the treatment of moderate-to-severe psoriasis is greatly reduced with use of SEC, due to its strong and sustained efficacy when compared to UST as observed in CLEAR study.