OBJECTIVES: To compare the cost per Psoriasis Area Severity Index (PASI) ≥75 and ≥90 responder (CPR) of secukinumab 300 mg (SEC) versus etanercept (ETN), infliximab (INF), and ustekinumab (UST) in patients with moderate to severe psoriasis from payer perspective in Thailand.

METHODS: A previously published 52-week decision-tree model reflecting response to treatment, defined as Psoriasis Area Severity Index (PASI) reduction of < 50, 50-74, 75-89, and ≥ 90, from the mixed treatment comparison comparing SEC, ETN, INF, and UST to placebo, was used to evaluate cost per responder. Responders at week 16 continued initial treatment. Non-responders and drop-out patients were switched to standard of care. Direct costs were derived from published local studies plus expert opinions and standard costs were converted to USD 2017 values.

RESULTS: SEC had the lowest cost per PASI ≥75 responder over 16 weeks ($5,041) compared with ETN ($13,540), INF ($15,863), and UST ($10,188). Over 52 weeks, cost per PASI ≥75 responder ranged from $11,464 (SEC) to 31,327 (INF). Similar results were found to the cost per PASI ≥90 responder. At week 16, costs per PASI ≥90 responder for SEC, ETN, INF, and UST were $6,476, $24,543, $22,742, and 15,066, respectively. At week 52, costs per PASI ≥90 responder for SEC, ETN, INF, and UST were $14,729, $48,054, $44,911, and 40,960, respectively. The cost per sustained PASI ≥75 and PASI ≥90 responder from week 16 to week 52 was lowest for SEC as compared to other biologics.

CONCLUSIONS: These finding indicates that SEC is cost-effective compared with all comparators by providing higher outcomes with lower cost for patient with moderate to severe psoriasis in Thailand.