title: Estimated cost efficacy of systemic treatments that are approved by the US Food and Drug Administration for the treatment of moderate to severe psoriasis.
abstract: BACKGROUND
  Newer psoriasis treatments tout higher efficacy but are generally more expensive.
  
  
  OBJECTIVE
  We sought to estimate the cost efficacy of systemic psoriasis treatments that have been approved by the US Food and Drug Administration (FDA).
  
  
  METHODS
  A literature review of systemic psoriasis treatments that have been approved by the FDA was performed for the primary end point of a 75% reduction in the Psoriasis Area and Severity Index score (PASI 75). Medication cost was referenced by wholesale acquisition cost (WAC), laboratory fees were obtained from the American Medical Association, and office visit fees are standard at our university. Total expenses were standardized by calculating cost per month of treatment considering the number needed to treat (NNT) to achieve PASI 75.
  
  
  RESULTS
  Methotrexate ($794.05-1502.51) and cyclosporine ($1410.14-1843.55) had the lowest monthly costs per NNT to achieve PASI 75. The most costly therapies were infliximab ($8704.68-15,235.52) and ustekinumab 90 mg ($12,505.26-14,256.75). Monthly costs per NNT to achieve PASI 75 for other therapies were as follows: narrowband ultraviolet B light phototherapy ($2924.73), adalimumab ($3974.61-7678.78), acitretin ($4137.71-14,148.53), ustekinumab 45 mg ($7177.89-7263.99), psoralen plus ultraviolet A light phototherapy ($7499.46-8834.98), and etanercept ($8284.71-10,674.89).
  
  
  CONCLUSIONS
  Drug rebates and incentives, potential adverse effects, comorbidity risk reduction, ambassador programs, and combination therapies were excluded.
  
  
  CONCLUSIONS
  Our study provides meaningful cost efficacy data that may influence psoriasis treatment selection.
authors: Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: dsouza@uchc.edu.
authors: Logan S
authors: LS
authors: D'Souza
authors: Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
authors: Michael J
authors: MJ
authors: Payette
mesh_terms: D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use; D019411:Clinical Laboratory Techniques / Q000191:economics; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data*; D017277:Drug Approval; D016527:Drug Costs / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics* / Q000627:therapeutic use; D009819:Office Visits / Q000191:economics; D011701:PUVA Therapy / Q000191:economics; D010778:Photochemotherapy / Q000191:economics; D011565:Psoriasis / Q000188:drug therapy / Q000191:economics* / Q000532:radiotherapy; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000191:economics; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents
keywords: biologics; cost effectiveness; methotrexate; phototherapy; psoriasis; psoriasis treatment