Abstract

Objectives

Secukinumab has demonstrated a promising efficacy among patients with psoriatic arthritis (PsA) who had an inadequate response to tumor necrosis factor inhibitors (TNF-IR). This study aimed to assess the cost-utility and budget impact of secukinumab compared with standard treatment among PsA patients who were TNF-IR in Thailand.

Methods

A hybrid model from a societal perspective was undertaken. Patients with PsA who were TNF-IR and aged 40 years were simulated. Secukinumab 150 mg, secukinumab 300 mg, and secukinumab 150 mg with escalated dose to 300 mg if not responded at 6 months (switching) were compared with standard of care. All inputs were collected from comprehensive literature review. The incremental cost-effectiveness ratio per quality-adjusted life-year (QALY) was calculated. A budget impact was also estimated.

Results

Secukinumab 150 mg, secukinumab 300 mg, and secukinumab switching had 0.10, 0.30, and 0.89 additional QALYs, respectively. However, secukinumab 150 mg required an additional lifetime cost of 74 783 Thai baht (THB) ($2149), whereas secukinumab 300 mg required 238 457 THB ($6851) and secukinumab switching required 338 540 THB ($9726). The incremental cost-effectiveness ratios for secukinumab 150 mg, secukinumab 300 mg, and secukinumab switching were 724 964 THB/QALY ($20 828/QALY), 793 652 THB/QALY ($22 802/QALY), and 380 445 THB ($10 930/QALY), respectively. Average net budget impacts for the first 5 year were 90 million THB ($2.95 million), 1117 million THB ($32.09 million), and 871 million ($25.02 million) for secukinumab 150 mg, secukinumab 300 mg, and secukinumab switching, respectively.

Conclusions

Secukinumab provided clinical benefits for PsA patients who were TNF-IR, but it is not a cost-effective option at its current price.