Cost per responder analysis of ustekinumab and etanercept for moderate to severe plaque psoriasis.
OBJECTIVE
To compare the cost per responder of ustekinumab with etanercept based on data from the active comparator ACCEPT trial.


METHODS
In ACCEPT, patients received ustekinumab 45 mg (n = 209) or 90 mg (n = 347) at weeks 0 and 4 or etanercept 50 mg (n = 347) twice weekly for 12 weeks. The proportions of patients achieving ≥75% improvement in the Psoriasis Area and Severity Index [PASI 75] were determined at week 12. The cost per PASI 75 responder was determined for week 16, a time coinciding with treatment coverage of both drugs and accounting for the different dosing intervals. Costs for 16 weeks of therapy were based on the Wholesale Acquisition Cost (WAC) in the United States. The analysis used weight-based efficacy results for ustekinumab (45 mg for patients ≤ 100 kg; 90 mg for patients > 100 kg) and overall efficacy for etanercept, consistent with the approved dosages.


RESULTS
A total of 28% of patients weighed > 100 kg. The PASI 75 response rates at week 12 were 72.2% for the ustekinumab 45 mg group in patients ≤ 100 kg, 65.0% for the ustekinumab 90 mg group in patients > 100 kg, and 56.8% for the etanercept group. At week 16, the cost per responder was $17,842 for ustekinumab and $20,077 for etanercept.


CONCLUSIONS
The cost per responder was lower for ustekinumab than for etanercept through 16 weeks in psoriasis patients.
Centocor Ortho Biotech Services, LLC, Horsham, PA 19044, USA. smarti51@its.jnj.com
Silas
S
Martin
Steven R
SR
Feldman
Matthias
M
Augustin
Philippe
P
Szapary
Brad
B
Schenkel
D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D016527:Drug Costs; D023381:Endpoint Determination; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000191:economics* / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D000069549:Ustekinumab
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000069549:Ustekinumab; D000068800:Etanercept