a Eli Lilly and Company , Lilly Corporate Center , Indianapolis , IN , USA.
b University of Cincinnati , Cincinnati , OH , USA.
J Med Econ. 2017 Dec;20(12):1224-1230. doi: 10.1080/13696998.2017.1362413. Epub 2017 Aug 22.
Evidence of the cost-efficacy of ixekizumab for the treatment of moderate-to-severe plaque psoriasis (PsO) in the US is limited.
To estimate the number needed to treat (NNT) and monthly cost of achieving one additional Psoriasis Area and Severity Index (PASI) 75, 90, and 100 responder for ixekizumab and other Food and Drug Administration (FDA)-approved biologics in PsO.
A network meta-analysis estimated the probability of achieving PASI 75, 90, or 100 response during induction for each biologic. NNTs were calculated using response difference of each respective biologic vs placebo at the end of induction. Monthly costs per additional PASI responder were based on FDA-approved doses, wholesale acquisition costs, and induction NNTs.
Induction NNTs for ixekizumab 80 mg once every 2 weeks (Q2W) relative to placebo were consistently lower across all levels of clearance compared with the other biologics. Monthly cost per additional responder was lowest for ustekinumab 45 mg at PASI 75 and for secukinumab 300 mg and ixekizumab 80 mg Q2W at PASI 90. Ixekizumab 80 mg Q2W had the lowest cost for PASI 100.
In this analysis, ixekizumab is the most cost-efficient biologic in the US when targeting complete resolution, as measured by PASI 100 in PsO.
在美国，伊克昔单抗治疗中重度斑块状银屑病（PsO）的成本效益证据有限。
评估伊克昔单抗与其他美国食品和药物管理局（FDA）批准的生物制剂治疗斑块状银屑病时，达到额外一个银屑病面积和严重程度指数（PASI）75、90 和 100 应答者所需的治疗人数（NNT）和每月成本。
通过网络荟萃分析估计每种生物制剂在诱导期达到 PASI 75、90 或 100 应答的概率。通过比较每个相应生物制剂与安慰剂在诱导期结束时的应答差异，计算 NNT。基于 FDA 批准的剂量、批发采购成本和诱导 NNT，计算每增加一个 PASI 应答者的每月成本。
与其他生物制剂相比，伊克昔单抗 80mg 每 2 周（Q2W）一次与安慰剂相比，在所有清除率水平上诱导 NNT 均较低。在 PASI 75 时，乌司奴单抗 45mg 的每增加一个应答者的每月成本最低，而在 PASI 90 时，司库奇尤单抗 300mg 和伊克昔单抗 80mg Q2W 的每月成本最低。伊克昔单抗 80mg Q2W 在 PASI 100 时的成本最低。
在这项分析中，伊克昔单抗是治疗斑块状银屑病时最具成本效益的生物制剂，以 PASI 100 作为完全缓解的衡量标准。
