OBJECTIVES: The objective of this analysis is to assess and compare the long term cost per responder (CPR) based on the American College of Rheumatology (ACR) outcomes following 48 weeks of treatment with Secukinumab (SEC150mg, 300mg) relative to Infliximab (INF, anti TNF) for the treatment of Psoriatic Arthritis (PsA) in Tunisia.

METHODS: The CPR for each treatment was calculated by dividing the acquisition cost of each drug by its response rate. Drug costs were estimated based on the Tunisian Central Pharmacy (PCT) database (currency in TND) and the number of doses required during 48 weeks.

The long-term response rates were derived from a matching-adjusted indirect comparison (MAIC) technique based on the data from FUTURE2 and IMPACT clinical trials of Secukinumab and Infliximab respectively.

RESULTS: MAIC analysis showed that ACR (20/50/70) response rates were significantly higher for SEC150mg and 300mg compared to INF at 48 weeks.

ACR 20 response rates were 88%, 77% and 59%, ACR 50 response rates were 45%, 68% and 37% whereas the ACR 70 response rates were 22%, 31% and 22% for SEC 150mg, SEC 300mg and INF respectively.

SEC 150mg has a lower CPR compared to INF among PsA patients for ACR (20/50) while for ACR 70 INF has the lowest CPR.

Cost per ACR 20 responder were TND26,849.00, TND60,782.00 and TND34,424.00, cost per ACR50 responder were TND52,526.00, TND69,633.00 and TND 55,287.00 whereas costs per ACR 70 responder were TND108,563.00, TND150,762.00 and TND91,224.00 for SEC150mg, SEC 300mg and INF respectively.

CONCLUSIONS: The long-term CPR for ACR (20/50) were lower for SEC 150 mg versus INF despite a 63% lower price per dose of Infliximab biosimilar compared to SEC in Tunisia. These findings support the economic advantage of SEC 150mg over INF in the treatment of PsA in Tunisia.