Cost-efficacy comparison of biological therapies for patients with moderate to severe psoriasis in Japan.
BACKGROUND
Biological therapies have recently been introduced for patients with moderate to severe psoriasis in Japan.


OBJECTIVE
This research aims to assess the cost efficacy of adalimumab, infliximab and ustekinumab treatments for psoriasis in a Japanese environment.


METHODS
A mixed-treatment comparison was performed to estimate the comparative efficacy of biological therapies using Psoriasis Area and Severity Index (PASI) scores based on data from randomized, double-blind, controlled studies. Costs included only the drug costs calculated by the approved dosing and schedule. Cost efficacy was determined by dividing the cost by the probability of achieving a PASI 75 response.


RESULTS
Infliximab had the highest probability of a PASI 75 response (83%), followed by ustekinumab 45 mg (74%) and adalimumab (59%). Infliximab was the most expensive biologic, whereas the costs of ustekinumab 45 mg and adalimumab were similar. In the first year of induction treatment, the lowest cost per responder was for ustekinumab 45 mg, followed by adalimumab and infliximab. In the subsequent year of maintenance treatment, the cost per responder of ustekinumab 45 mg remained the lowest while infliximab and adalimumab had similar cost efficacy.


CONCLUSIONS
Ustekinumab was a more cost-efficient biological therapy than adalimumab or infliximab for psoriasis patients in a Japanese setting.
Department of Dermatology, NTT Medical Center Tokyo, Tokyo, Japan. igarashi@east.ntt.co.jp
Atsuyuki
A
Igarashi
Hiroyo
H
Kuwabara
Kyle
K
Fahrbach
Brad
B
Schenkel
D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000191:economics / Q000627:therapeutic use; D001688:Biological Products / Q000191:economics* / Q000627:therapeutic use; D001691:Biological Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D006801:Humans; D000069285:Infliximab; D007564:Japan; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D000069549:Ustekinumab
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab