Cost-effectiveness of biologic treatments for psoriasis based on subjective and objective efficacy measures assessed over a 12-week treatment period - 24/04/13
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Abstract |
Background |
The cost-effectiveness of biologic agents is not well delineated.
Objective |
To determine the cost-effectiveness of biologic agents in cost per patient achieving a minimally important difference in Dermatology Life Quality Index (DLQI MID) and cost per patient achieving a 75% improvement in Psoriasis Area Severity Index (PASI-75), assessed over a 12-week period.
Method |
Efficacies of the agents were determined through a literature review; treatment paradigms and associated costs were determined. The cost-effectiveness of the agents was determined and sensitivity analysis performed.
Results |
Etanercept at a dose of 25 mg administered subcutaneously (SQ) once weekly was the most cost-effective agent in cost per patient achieving DLQI minimally important difference; infliximab at a dose of 3 mg/kg administered intravenously (IV) for 3 infusions, adalimumab at a dose of 40 mg SQ every other week, and etanercept at a dose of 25 mg SQ twice weekly were the next most cost-effective agents in cost per patient achieving the DLQI minimally important difference. Intravenous infliximab at a dose of 3 mg/kg was the most cost-effective agent in terms of cost per patient achieving PASI-75 improvement; intravenous infliximab at a dose of 5 mg/kg and adalimumab at a dose of 40 mg SQ every other week were the next most cost-effective agents in cost per patient achieving PASI-75 improvement.
Limitations |
This study had a limited time horizon of 12 weeks; generalizing the results to longer treatment periods may not be accurate and is not advisable. Additionally, when sensitivity analyses were performed, multiple agents had overlapping cost-effectiveness ratios at relatively low levels of variance; thus it may not be accurate to differentiate the cost-effectiveness of these agents.
Conclusions |
Different biologic agents for psoriasis appear to have different cost-effectiveness values; within the limitations of the available data, infliximab and adalimumab appear to be the most cost-effective agents.
Le texte complet de cet article est disponible en PDF.Abbreviations used : DLQI, DLQI MID, FDA, HRQOL, IV, MID, PASI-75, QOL, RCT, SQ
Plan
The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, L.P. |
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Disclosure: Dr Feldman has received research, speaking, and/or consulting support from Abbott, Amgen, Astellas, Biogen, Centocor, Connetics, Genentech, and Roche. Dr Pearce has been a consultant for Biogen. Drs Nelson, Fleischer, and Balkrishnan have no conflicts of interest to declare. |
Vol 58 - N° 1
P. 125-135 - janvier 2008 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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