Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Patient Access Team, Novartis Korea, Seoul, Korea.
Int J Rheum Dis. 2019 Sep;22(9):1630-1637. doi: 10.1111/1756-185X.13635. Epub 2019 Jun 18.
To compare the cost-effectiveness of secukinumab vs adalimumab at 1 and 2 years of treatment in patients with ankylosing spondylitis (AS) by analyzing the cost per responder reported in randomized controlled trials (RCTs) from the Korean perspective.
A systematic literature search was performed via PubMed for relevant RCTs for comparing the response rate in patients with AS. The response rates in anti-tumor necrosis factor-naive subjects were extracted from RCTs and cost per responder analyses were calculated in case of both with or without a loading dosage of secukinumab compared with adalimumab.
The Assessment in AS International Working Group (ASAS) 20 and 40 response rates of secukinumab from the MEASURE 2 trial and those of adalimumab from the ATLAS trial were comparable. The cost per ASAS 20 responder was lower by 40% in secukinumab compared to adalimumab: USD9637 vs 16 129 at 52 weeks and USD20 051 vs 32 699 at 104 weeks for secukinumab (in maintenance dosing) vs adalimumab, respectively. The cost per ASAS 40 responder was also lower by 40% in secukinumab: USD12 179 vs 22 395 at 52 weeks and USD27 338 vs 41 655 at 104 weeks for secukinumab vs adalimumab, respectively. With a loading dosage of secukinumab at 52 and 104 weeks, secukinumab showed lower costs per responder by 25% compared to adalimumab.
The costs per responder associated with ASAS 20 and 40 response rates were consistently lower for secukinumab compared with adalimumab. The treatment with secukinumab for patients with AS could be a cost-saving treatment option in South Korea.
通过分析韩国视角下随机对照试验（RCT）中报告的应答者成本，比较司库奇尤单抗与阿达木单抗在治疗强直性脊柱炎（AS）患者 1 年和 2 年的成本效益。
通过 PubMed 对比较 AS 患者应答率的相关 RCT 进行系统文献检索。从 RCT 中提取初治肿瘤坏死因子（TNF）的应答率，并计算司库奇尤单抗与阿达木单抗比较时有无负荷剂量的应答者成本。
MEASURE 2 试验中司库奇尤单抗的 ASAS20 和 40 应答率和 ATLAS 试验中阿达木单抗的 ASAS20 和 40 应答率相当。与阿达木单抗相比，司库奇尤单抗在第 52 周时 ASAS20 应答者的成本降低了 40%：分别为 9637 美元和 16129 美元；在第 104 周时 ASAS20 应答者的成本降低了 40%：分别为 20051 美元和 32699 美元，用于维持剂量的司库奇尤单抗和阿达木单抗。在第 52 周时，司库奇尤单抗的 ASAS40 应答者成本也降低了 40%：分别为 12179 美元和 22395 美元；在第 104 周时，司库奇尤单抗的 ASAS40 应答者成本也降低了 40%：分别为 27338 美元和 41655 美元，用于维持剂量的司库奇尤单抗和阿达木单抗。在第 52 周和第 104 周时，与阿达木单抗相比，司库奇尤单抗的应答者成本分别降低了 25%。
与阿达木单抗相比，司库奇尤单抗在 ASAS20 和 40 应答率方面的应答者成本始终更低。对于韩国的 AS 患者，司库奇尤单抗的治疗可能是一种节省成本的治疗选择。
