title: Cost-efficacy of biologic therapies for moderate to severe psoriasis from the perspective of the Taiwanese healthcare system.
abstract: BACKGROUND
  Biologic therapies are more effective than conventional therapies in the treatment of psoriasis, but they are also more costly.
  
  
  OBJECTIVE
  The aim of this study was to compare the cost-efficacy of etanercept, adalimumab, and ustekinumab therapies in the treatment of moderate to severe psoriasis in a Taiwanese setting.
  
  
  METHODS
  We conducted a meta-analysis of randomized, placebo-controlled trials to calculate the incremental efficacy of etanercept, adalimumab, and ustekinumab, respectively, in affecting a reduction of ≥75% in score on the Psoriasis Area and Severity Index (PASI 75). The base, best case, and worst case incremental cost-effectiveness ratios (ICERs) for one subject to achieve PASI 75 were calculated for the purposes of economic analysis.
  
  
  RESULTS
  One-year ICERs per PASI 75 responder were US$ 39,709 (best scenario US$ 36,400; worst scenario US$ 43,680), US$ 23,711 (best scenario US$ 22,633; worst scenario US$ 25,319), and US$ 26,329 (best scenario US$ 24,780; worst scenario US$ 27,623) for etanercept, adalimumab, and ustekinumab, respectively. Two year ICERs per PASI 75 responder were US$ 71,973 (best scenario US$ 65,975; worst scenario US$ 79,170), US$ 62,665 (best scenario US$ 59,817; worst scenario US$ 66,914), and US$ 52,657 (best scenario US$ 49,560; worst scenario US$ 55,427) for etanercept, adalimumab, and ustekinumab, respectively.
  
  
  CONCLUSIONS
  In a Taiwanese setting, adalimumab and ustekinumab had lower 1-year costs per PASI 75 responder than etanercept, and ustekinumab had the lowest 2-year cost per PASI 75 responder.
authors.affiliation: Department of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Department of Healthcare Administration, Oriental Institute of Technology, New Taipei, Taiwan; Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Wang
authors.forename: Ching-Chi
authors.initials: CC
authors.lastname: Chi
authors.forename: Sindy
authors.initials: S
authors.lastname: Hu
mesh_terms: D000068879:Adalimumab; D061067:Antibodies, Monoclonal, Humanized / Q000191:economics / Q000627:therapeutic use; D001688:Biological Products / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000191:economics / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics; D016032:Randomized Controlled Trials as Topic; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012720:Severity of Illness Index; D013624:Taiwan; D000069549:Ustekinumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000069549:Ustekinumab; D000068879:Adalimumab; D000068800:Etanercept