OBJECTIVES: To estimate the cost per responder of psoriasis treatment with secukinumab 300mg versus etanercept biosimilar 50mg from the Portuguese National Health System (NHS).

METHODS: The cost per responder for each treatment was estimated by dividing the drug acquisition cost of a 52-week course of treatment with its response rate based on the Psoriasis Area Severity Index outcomes (PASI75, PASI90 and PASI100). Drug acquisition costs were estimated using 2018 official prices from the perspective of the NHS; number of doses required for the course of treatment were defined according to the approved EU label. Response rates were obtained from the FIXTURE clinical trial of secukinumab versus etanercept.

RESULTS: PASI75, PASI90 and PASI100 response rates for secukinumab were 79%, 65% and 36% versus 55%, 33% and 10% for etanercept biosimilar, respectively. The 52-week cost of secukinumab was €13,477 versus €7,176 for biosimilar etanercept. The budget to obtain 100 PASI100 responders with etanercept biosimilar will allow to obtain 192 responders with secukinumab instead. Cost per PASI75 responder for secukinumab and etanercept biosimilar was €17,058 versus €13,047, cost per PASI90 responder was €20,734 versus €21,746, and cost per PASI100 responder was €37,436 versus €71,760, respectively.

CONCLUSIONS: Response rates were higher for secukinumab compared to etanercept biosimilar at 52 weeks for all PASI outcomes. Cost estimates per PASI75 and PASI100 (i.e. clear skin) responder were lower for secukinumab. These findings indicate that it is more efficient to treat psoriatic patients with secukinumab than with etanercept biosimilar in the Portuguese NHS when considering the most difficult-to-reach outcomes.