Warren R B, Halliday A, Graham C N, Gilloteau I, Miles L, McBride D
The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Novartis Pharmaceuticals UK Limited, Frimley/Camberley, UK.
J Eur Acad Dermatol Venereol. 2018 Dec;32(12):2178-2184. doi: 10.1111/jdv.15094. Epub 2018 Jul 15.
Psoriasis causes work productivity impairment that increases with disease severity. Whether differential treatment efficacy translates into differential indirect cost savings is unknown.
To assess work hours lost and indirect costs associated with secukinumab versus ustekinumab and etanercept in the United Kingdom (UK).
This was a post hoc analysis of work impairment data collected in the CLEAR study (secukinumab vs. ustekinumab) and applied to the FIXTURE study (secukinumab vs. etanercept). Weighted weekly and annual average indirect costs per patient per treatment were calculated from (i) overall work impairment derived from Work Productivity and Activity Impairment data collected in CLEAR at 16 and 52 weeks by Psoriasis Area and Severity Index (PASI) response level; (ii) weekly/annual work productivity loss by PASI response level; (iii) weekly and annual indirect costs by PASI response level, based on hours of work productivity loss; and (iv) weighted average indirect costs for each treatment. In the primary analysis, work impairment data for employed patients in CLEAR at Week 16 were used to compare secukinumab and ustekinumab. Secondary analyses were conducted at different time points and with patient cohorts, including FIXTURE.
In CLEAR, 452 patients (67%) were employed at baseline. At Week 16, percentages of weekly work impairment/mean hours lost decreased with higher PASI: PASI < 50: 22.8%/7.60 h; PASI 50-74: 13.3%/4.45 h; PASI 75-89: 6.4%/2.14 h; PASI ≥ 90: 4.9%/1.65 h. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than ustekinumab (1.96/102.51 vs. 2.40/125.12; P = 0.0006). Results were consistent for secukinumab versus etanercept (2.29/119.67 vs. 3.59/187.17; Ρ<0.0001). Average annual indirect cost savings with secukinumab were £355 vs. ustekinumab and £1061 versus etanercept. Results at 52 weeks were similar.
Secukinumab significantly reduced work impairment and associated indirect costs of psoriasis compared with ustekinumab and etanercept at Week 16 through 52 in the United Kingdom.
银屑病会导致工作效率受损，且随着疾病严重程度的增加而加剧。不同治疗方法的疗效差异是否会转化为间接成本节省的差异尚不清楚。
评估在英国，司库奇尤单抗与优特克单抗和依那西普相比，所导致的工作时长损失和间接成本。
这是一项对在CLEAR研究（司库奇尤单抗对比优特克单抗）中收集的工作受损数据进行的事后分析，并应用于FIXTURE研究（司库奇尤单抗对比依那西普）。根据以下数据计算每位患者每种治疗的加权每周和每年平均间接成本：(i) 根据银屑病面积和严重程度指数（PASI）反应水平，由CLEAR在第16周和第52周收集的工作效率和活动受损数据得出的总体工作受损情况；(ii) 按PASI反应水平划分每周/每年的工作效率损失；(iii) 根据工作效率损失小时数，按PASI反应水平划分每周和每年的间接成本；以及(iv) 每种治疗的加权平均间接成本。在主要分析中，使用CLEAR研究中第16周就业患者的工作受损数据来比较司库奇尤单抗和优特克单抗。在不同时间点和不同患者队列（包括FIXTURE研究）中进行了二次分析。
在CLEAR研究中，452名患者（67%）在基线时就业。在第16周，随着PASI升高，每周工作受损百分比/平均损失小时数下降：PASI < 50：22.8%/7.60小时；PASI 50 - 74：13.3%/4.45小时；PASI 75 - 89：6.4%/2.14小时；PASI≥90：4.9%/1.65小时。司库奇尤单抗的加权平均每周/每年工作时长损失显著低于优特克单抗（1.96/102.51对比2.40/125.12；P = 0.0006）。司库奇尤单抗与依那西普对比的结果一致（2.29/119.67对比3.59/187.17；P<0.0001）。司库奇尤单抗每年平均间接成本节省为355英镑，对比优特克单抗，对比依那西普则为1061英镑。第5周的结果相似。
在英国，从第16周到第52周，与优特克单抗和依那西普相比，司库奇尤单抗显著降低了银屑病的工作受损及相关间接成本。
