Centocor Ortho Biotech Services, LLC, Horsham, PA 19044, USA.
J Dermatolog Treat. 2011 Jun;22(3):138-43. doi: 10.3109/09546634.2010.542800. Epub 2011 Jan 22.
To compare the cost per responder of ustekinumab with etanercept based on data from the active comparator ACCEPT trial.
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.
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.
The cost per responder was lower for ustekinumab than for etanercept through 16 weeks in psoriasis patients.
基于活性对照 ACCEPT 试验的数据，比较乌司奴单抗与依那西普的应答者成本。
在 ACCEPT 中，患者在 0 周和 4 周时分别接受乌司奴单抗 45 毫克（n=209）或 90 毫克（n=347），或依那西普 50 毫克（n=347）每周两次，共 12 周。在第 12 周确定达到银屑病面积和严重程度指数[PASI 75]改善≥75%的患者比例。在第 16 周确定 PASI 75 应答者的成本，这一时间与两种药物的治疗覆盖范围相吻合，并考虑了不同的给药间隔。16 周治疗的成本基于美国的批发采购成本（WAC）。分析使用了基于体重的乌司奴单抗疗效结果（体重≤100 公斤的患者为 45 毫克；体重>100 公斤的患者为 90 毫克）和依那西普的总体疗效，与批准的剂量一致。
共有 28%的患者体重>100 公斤。在体重≤100 公斤的患者中，乌司奴单抗 45 毫克组第 12 周的 PASI 75 应答率为 72.2%，乌司奴单抗 90 毫克组为 65.0%，依那西普组为 56.8%。在第 16 周，应答者的成本分别为乌司奴单抗 17842 美元和依那西普 20077 美元。
在银屑病患者中，乌司奴单抗的应答者成本比依那西普低，持续至第 16 周。
