Department of Dermatology, Nippon Medical School, Tokyo, Japan.
Market Access, AbbVie GK, Tokyo, Japan.
J Dermatolog Treat. 2022 Feb;33(1):229-239. doi: 10.1080/09546634.2020.1744505. Epub 2020 Apr 17.
To evaluate the cost-effectiveness of risankizumab versus other biologic treatments (adalimumab, infliximab, ustekinumab, secukinumab, brodalumab, ixekizumab, and guselkumab) of moderate-to-severe psoriasis in Japan.
A Markov cohort-level model was constructed to estimate quality-adjusted life years (QALYs) and costs for each treatment over a lifetime horizon. The model simulated patients' transition through one line of active biologic therapy followed by best supportive care and death. Transition probabilities were informed by network meta-analyses of Psoriasis Activity and Severity Index responses and adverse event-related discontinuation in clinical trials, as well as published real-world evidence and national mortality rates. Costs were evaluated from the health system, societal, and patient out-of-pocket perspectives.
Risankizumab was expected to provide 0.30-0.89 additional QALYs versus comparator biologics. Under the health system perspective, incremental cost-effectiveness ratios (ICERs) of risankizumab ranged from ¥2,545,812/QALY versus ustekinumab to ¥6,077,134/QALY versus adalimumab. Societal ICERs were lower, ranging from ¥921,770/QALY to ¥4,350,879/QALY. From the patient perspective, risankizumab was estimated to be cost-saving versus four comparators and was associated with ICERs of <¥500,000/QALY versus the remaining comparators.
Risankizumab was associated with higher QALYs and, based on typical willingness-to-pay benchmarks (¥5-6.7 million/QALY), considered cost-effective versus other biologics for the treatment of psoriasis in Japan.
评估 risankizumab 与其他生物制剂（阿达木单抗、英夫利昔单抗、乌司奴单抗、司库奇尤单抗、布罗达单抗、依奇珠单抗和古塞奇尤单抗）治疗中重度银屑病在日本的成本效益。
构建了一个马尔可夫队列水平模型，以估计每种治疗方法在整个生命周期内的质量调整生命年（QALY）和成本。该模型模拟了患者从一线生物治疗转为最佳支持治疗和死亡的过程。转移概率由网络荟萃分析的银屑病活动和严重程度指数反应和临床试验中与不良事件相关的停药率，以及已发表的真实世界证据和国家死亡率来提供信息。成本从卫生系统、社会和患者自付费用的角度进行评估。
risankizumab 预计与对照生物制剂相比，可额外提供 0.30-0.89 个 QALY。从卫生系统角度来看，risankizumab 的增量成本效益比（ICER）范围从 ustekinumab 的每 QALY 2545812 日元到 adalimumab 的每 QALY 6077134 日元。社会 ICER 更低，范围从每 QALY 921770 日元到每 QALY 4350879 日元。从患者角度来看，risankizumab 与四种对照药物相比具有成本效益，并且与其他生物制剂相比，ICER 低于每 QALY 500000 日元。
risankizumab 与更高的 QALY 相关，并且根据典型的意愿支付基准（每 QALY 500 万至 670 万日元），在日本治疗银屑病方面被认为比其他生物制剂更具成本效益。
