Department of Dermatology, NTT Medical Center Tokyo, Tokyo, Japan.
J Dermatolog Treat. 2013 Oct;24(5):351-5. doi: 10.3109/09546634.2012.697111. Epub 2012 Jul 9.
Biological therapies have recently been introduced for patients with moderate to severe psoriasis in Japan.
This research aims to assess the cost efficacy of adalimumab, infliximab and ustekinumab treatments for psoriasis in a Japanese environment.
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.
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.
Ustekinumab was a more cost-efficient biological therapy than adalimumab or infliximab for psoriasis patients in a Japanese setting.
生物疗法最近在日本被引入用于治疗中重度银屑病患者。
本研究旨在评估阿达木单抗、英夫利昔单抗和乌司奴单抗治疗日本环境中银屑病的成本效益。
采用混合治疗比较，根据随机、双盲、对照研究的数据，基于银屑病面积和严重程度指数（PASI）评分，评估生物疗法的相对疗效。成本仅包括按批准剂量和方案计算的药物成本。成本效益通过将成本除以达到 PASI 75 反应的概率来确定。
英夫利昔单抗达到 PASI 75 反应的概率最高（83%），其次是乌司奴单抗 45mg（74%）和阿达木单抗（59%）。英夫利昔单抗是最昂贵的生物制剂，而乌司奴单抗 45mg 和阿达木单抗的成本相似。在诱导治疗的第一年，每例应答者的最低成本为乌司奴单抗 45mg，其次是阿达木单抗和英夫利昔单抗。在随后的维持治疗年中，乌司奴单抗 45mg 的每例应答者成本仍然最低，而英夫利昔单抗和阿达木单抗的成本效益相似。
在日本环境中，与阿达木单抗或英夫利昔单抗相比，乌司奴单抗是一种更具成本效益的生物疗法。
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