Table 3.
Summary of cost-effectiveness analyses of biological agents for psoriasis based on US pricing [75]
Copyright © Cheng J, Feldman SR. Reproduced with permission from Drugs in Context. DOI:10.7573/dic.212266
| Study | Number of trials | Cost methodology | Efficacy methodology | Most cost-effective biologic |
|---|---|---|---|---|
| Hankin et al. [85] | 16 studies (1966–2004) | Annual cost (AWP, treatment administration, adverse-event monitoring and treatment, reimbursement rate from Medicare) | PASI% between 6 and 14 weeks | Infliximab 5 mg/kg at weeks 0, 2, and 6 |
| Menter et al. [86] | 3 RCTs | 18 months of treatment (AWP, office fees, injection fees, costs due to adverse events, laboratory monitoring) | PASI-75 at 18 months | Etanercept 50 mg twice weekly × 12 weeks, then 50 mg weekly |
| Miller et al. [73] | 16 studies | Annual cost (treatment administration, adverse-event monitoring and treatment) | PASI% (treatment period not specified) | Infliximab 5 mg/kg |
| Pearce et al. [87] | 13 RCTs (1998–2004) | 12 weeks of treatment (AWP, physician visits, laboratory tests, Medicare fee for schedule of infusions) | PASI-75 after 12 weeks | Infliximab 5 mg/kg |
| Nelson et al. [88] | 11 RCTs (2003–2007) | 12 weeks of treatment (AWP, physician visits, laboratory testing, Medicare fee for schedule of infusions) | PASI-75, DLQI after 12 weeks | Etanercept 25 mg once weekly (DLQI MID) Infliximab 3 mg/kg (PASI 75) |
| Hankin et al. [89] | 22 RCTs (1966–2008) | Annual cost (WAC, adverse event monitoring and treatment, Medicare fee for schedule of infusions) | PASI-75, PGA 0/1 after 6–14 weeks of treatment | Infliximab 5 mg/kg at weeks 0, 2, 6, then every 8 weeks |
| Staidle et al. [90] | 22 RCTs (2001–2011) | Annual cost (AWP, office visits, laboratory tests, monitoring procedures) | PASI-75, DLQI MID after 12 weeks of treatment | Infliximab 5 mg/kg every 8 weeks (PASI and DLQI) |
| Anis et al. [91] | 22 RCTs | 10–16 weeks of treatment (AWP, treatment administration, monitoring, laboratory tests) | PASI between 10–16 weeks | Adalimumab 40 mg every other week (QALY) |
| Martin et al. [92] | ACCEPT trial (ustekinumab, etanercept) | 16 weeks of treatment (WAC) | PASI-75 after 12 weeks | Ustekinumab (45 mg or 90 mg depending on weight) |
| Villacorta et al. [93] | ACCEPT trial (ustekinumab, etanercept) | 3 years of treatment (Medicare Part B average sales price, treatment of adverse events, physician visits) | PASI after 12 weeks | Ustekinumab 45 mg ($150,000 threshold per QALY) |
| Ahn et al. [74] | 27 RCTs (1995–2012) | 12 weeks of treatment (AWP, physician visits, laboratory tests, Medicare fee for schedules of IV procedures) | PASI-75, DLQI after 12 weeks | Infliximab 3 mg/kg (PASI 75 and DLQI) |
| Chi et al. [94] | 13 RCTs (2005–2012) | 6 months of treatment (AWP) | PASI-75 and PGA 0/1 after 6 months | Adalimumab 80 mg loading dose, then 40 mg every other week (PASI 75 and PGA 0/1) |
ACCEPT Active Comparator (CNTO1275/Enbrel) Psoriasis Trial, AWP Average wholesale price, DLQI Dermatology Life Quality Index, MID Minimally important difference, PASI Psoriasis Area and Severity Index, PGA 0/1 Physician Global Assessment clear/minimal, QALY Quality-adjusted life year, RCT randomized controlled trial, WAC wholesale acquisition cost
aStudy included non-biologic agents (i.e., phototherapy, cyclosporine, methotrexate, acitretin)