OBJECTIVES

: This analysis aimed to evaluate and compare the long-term cost per response of secukinumab 150 mg versus adalimumab at 52 weeks of treatment in ankylosing spondylitis (AS).

METHODS

: Response was assessed as achieving the Assessment of Spondyloarthritis International Society (ASAS) outcomes in a TNF-naïve population. The cost per response was calculated as the cost of treatment divided by the number of responders for each ASAS outcome. The outcomes assessed were ASAS 20, ASAS 40 and ASAS 5/6. List price of drugs for year 2018 were obtained from Saudi Food and Drug Authority website. The overall drug cost per treatment were calculated by multiplying drug cost per dose by the number of doses required during the treatment period. Matching-adjusted indirect comparison approach was employed to obtain long-term ASAS response rates based on the data from MEASURE 2 (secukinumab) and ATLAS (adalimumab) clinical trials. Sensitivity analysis were conducted to confirm robustness of analysis.

RESULTS

: Secukinumab achieved significantly greater ASAS responses (20, 40 and 5/6) in comparison to adalimumabCost per response for secukinumab was lower for all ASAS (20, 40, 5/6) outcomes. Cost per response for secukinumab in comparison to adalimumab for ASAS 20, ASAS 40 and ASAS 5/6 was SR 59,970/SR 114,495, SR 77,961/158,981 and SR 65,319/135,407, respectively. If a payer allocates a budget of SR 160,000 for AS treatment, treatment with secukinumab would result in twice the number of ASAS (20, 40 and 5/6) responders compared to adalimumab. The sensitivity analysis confirmed robustness of the analysis.

CONCLUSIONS

: Biologic treatment with secukinumab for AS patients in Saudi Arabia is a cost-effective option. Secukinumab has lower cost per ASAS response in comparison to adalimumab. The budget savings generated can enable treatment of greater number of AS patients using secukinumab compared to adalimumab.