Cortesi Paolo Angelo, Fornari Carla, Gisondi Paolo, Iannone Florenzo, Antonazzo Ippazio Cosimo, Aloisi Elisabetta, Fiocchi Martina, Ritrovato Daniela, Mantovani Lorenzo Giovanni
Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy.
Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
Pharmacoecon Open. 2023 May;7(3):405-416. doi: 10.1007/s41669-023-00404-3. Epub 2023 Mar 16.
Recent developments improved outcomes in patients with autoimmune diseases. Biologics were approved as first-line treatment in selected naïve patients with plaque psoriasis (PsO), psoriatic arthritis (PsA), ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). Among them, secukinumab was most recently approved for treatment of active nr-axSpA in adults. In this work, we assessed the budget impact of new secukinumab treatment options in the Italian market.
A cross-indication budget impact model was designed to estimate the effects of adding secukinumab in the Italian market from the National Health System perspective over a 3-year period. The model included all adults with PsO, PsA, AS and nr-axSpA, treated with biologics or biosimilars. It compared costs between two scenarios, secukinumab availability or absence, for the four diseases combined and taken individually. A sensitivity analyses was conducted.
There were 68,121 adult patients treated with biologics in 2021 and 68,341 in 2023. The budget impact analysis (BIA) on all indications showed a cost reduction of €33.7 million (- 1.5%) over 3 years with the introduction of secukinumab. PsA patients had the highest saving (- €34.9 million), followed by PsO patients (- €7.8 million). Cost saving in PsO patients was balanced by increased budget reported in AS patients (+ €8.0 million). In nr-axSpA patients, secukinumab reported no significant budget increase (+ 1.0%).
This BIA accounted for the new indication of secukinumab in nr-axSpA patients, reporting no significant changes in the required budget and adding an effective treatment option. Considering all indications, secukinumab is a sustainable treatment option.
近期的进展改善了自身免疫性疾病患者的治疗效果。生物制剂已被批准作为某些初治斑块状银屑病（PsO）、银屑病关节炎（PsA）、强直性脊柱炎（AS）和非放射学中轴型脊柱关节炎（nr-axSpA）患者的一线治疗药物。其中，司库奇尤单抗最近被批准用于治疗成人活动性nr-axSpA。在本研究中，我们评估了意大利市场上新的司库奇尤单抗治疗方案的预算影响。
设计了一个跨适应症预算影响模型，从国家卫生系统的角度估计在意大利市场引入司库奇尤单抗在3年内的影响。该模型纳入了所有接受生物制剂或生物类似药治疗的PsO、PsA、AS和nr-axSpA成年患者。它比较了两种情况（有或无私库奇尤单抗）下四种疾病合并及单独考虑时的成本。进行了敏感性分析。
2021年有68,121名成年患者接受生物制剂治疗，2023年有68,341名。对所有适应症的预算影响分析（BIA）显示，引入司库奇尤单抗后，3年内成本降低了3370万欧元（-1.5%）。PsA患者节省最多（-3490万欧元），其次是PsO患者（-780万欧元）。PsO患者的成本节省被AS患者报告的预算增加（+800万欧元）所平衡。在nr-axSpA患者中，司库奇尤单抗报告预算无显著增加（+1.0%）。
该BIA考虑了司库奇尤单抗在nr-axSpA患者中的新适应症，报告所需预算无显著变化，并增加了一种有效的治疗选择。考虑到所有适应症，司库奇尤单抗是一种可持续的治疗选择。
