OBJECTIVES

: Secukinumab 300 mg, a fully human interleukin-17A antibody, has demonstrated superior and sustained efficacy in treatment of adults with moderate to severe psoriasis over other biologic treatments. The analysis compared the cost per responder of secukinumab (SEC) as first-line biologic treatment versus adalimumab (ADA), etanercept (ETN), infliximab (INF), ustekinumab (UST) and placebo.

METHODS

: A 52-week decision-tree model reflecting response to treatment defined as Psoriasis Area Severity Index (PASI) reduction of ≥90%, from a mixed-treatment comparison, led into a Markov model to evaluate the cost per response for each treatment. Responders (PASI≥90) at week 16 continued the initial treatment. Non-responders and drop-outs were switched to standard of care. Analyses were conducted for responders at week 16, week 52 and for sustained responders between weeks 16 and 52, from a Saudi Arabian perspective over a 1-year time horizon. Costs for each treatment included the drug and resource costs, obtained from the Saudi Food and Drug Authority website and national sources respectively, for 2018. No discount was applied.

RESULTS

: SEC 300 mg had the lowest cost per PASI≥90 responder at 52 weeks (SAR148,952), compared with UST (SAR166,923), INF (SAR175,876), ADA (SAR198,825) or ETN (SAR228,029). Likewise, SEC had the lowest cost per sustained 52-week PASI≥90 responder (SAR80,648) and ADA the highest (SAR105,023). At week 16, cost per PASI≥90 responder was lower for SEC (SAR64,326) versus ADA (SAR 86,785), ETN (SAR115,804) and INF (SAR86,160) except UST (SAR61,035). Sensitivity analysis supported the robustness of the results.

CONCLUSIONS

: Secukinumab as first-line biologic treatment of adults with moderate to severe psoriasis has the lowest cost per PASI≥90 responder compared with other biologic treatments in Saudi Arabia over 1 year.