Biologics in the treatment of psoriasis: clinical and economic overview.
BACKGROUND
The use of biologic medications for psoriasis is a recent therapeutic advance.


OBJECTIVE
To review clinical and economic data for biologic therapies in the treatment of chronic plaque psoriasis.


METHODS
Published meta-analyses and additional literature review identified randomized controlled trials. Analyses included the number needed to treat (NNT), the cost in Canadian dollars for the first year of treatment per the Canadian product monograph, and the estimated cost per responder achieving a 75% reduction in Psoriasis Area and Severity Index score (PASI 75).


RESULTS
Pooled NNTs were 1.3 (infliximab), 1.5 (ustekinumab 90 mg), 1.6 (adalimumab and ustekinumab 45 mg), 2.3 (etanercept), 4.1 (efalizumab), and 5.6 (alefacept). The annual treatment cost per patient was $19,825 to $37,600. The cost per patient achieving a PASI 75 response at 12 weeks ranged from $8,330 (adalimumab) to $71,371 (alefacept).


CONCLUSIONS
This analysis suggests favorable cost and benefits of biologic psoriasis therapies, particularly adalimumab, infliximab, and ustekinumab.
Poulin
Yves
Y
Hôpital Hôtel-Dieu de Québec and Centre Dermatologique du Québec Métropolitan, Quebec City, QC.
Langley
Richard G
RG
Teixeira
Henrique D
HD
Martel
Marie-Josée
MJ
Cheung
Sun
S
D000893:Anti-Inflammatory Agents / Q000191:economics* / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use*; D002170:Canada; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy / Q000191:economics / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal