LEO Pharma AS, Ballerup, Denmark.
EY, Frederiksberg, Denmark.
Curr Med Res Opin. 2023 Jun;39(6):833-842. doi: 10.1080/03007995.2023.2214046. Epub 2023 May 23.
The treatment of moderate-to-severe plaque psoriasis has seen significant improvements in recent years with the advent of biologic drugs. The aim of this study was to assess the cost-effectiveness of anti-IL17 drugs and other biologic therapies used to treat moderate-to-severe plaque psoriasis in France and Germany over a one-year time horizon.
We developed a cost per responder model for biologic drugs used in psoriasis treatment. The model included anti-IL17s (brodalumab, secukinumab, ixekizumab and bimekizumab), anti-TNFs (adalimumab, etanercept, certolizumab and infliximab), an anti-IL12/23 (ustekinumab), and anti-IL23s (risankizumab, guselkumab and tildrakizumab). Efficacy estimates were collected through a systematic literature review of network meta-analyses on long-term Psoriasis Area and Severity Index (PASI) measures. Dose recommendations and country-specific prices were used to calculate drug costs. Biosimilar drug prices were used when available as a substitute for the originator drugs.
After one year, brodalumab had the lowest cost per PASI100-responder in both France (€20,220) and Germany (€26,807) across all available biologic treatments. Among the anti-IL17s, brodalumab had a 23% lower cost per PASI100-responder vs. the nearest comparator in France (bimekizumab, €26,369), and 30% lower vs. nearest comparator in Germany (ixekizumab, €38,027). Brodalumab also had the lowest cost per PASI75- and PASI90-responder among the anti-IL17s in both France and Germany after one year. Adalimumab had the lowest cost per PASI100-responder among the anti-TNFs in both France (€23,418) and Germany (€38,264). Among the anti-IL-23s, risankizumab had the lowest cost per PASI100-responder in both France (€20,969) and Germany (€26,994).
Driven by its lower costs and high response rates, brodalumab was the most cost-effective treatment option for moderate-to-severe plaque psoriasis over a one-year time-horizon within the anti-IL17 class and when compared to all other biologics in France and Germany.
近年来，随着生物制剂的出现，中重度斑块状银屑病的治疗取得了显著进展。本研究旨在评估在法国和德国，一年内使用抗 IL17 药物和其他生物疗法治疗中重度斑块状银屑病的成本效益。
我们为银屑病治疗中的生物药物开发了一种应答者成本模型。该模型包括抗 IL17 药物（布罗达卢单抗、司库奇尤单抗、依奇珠单抗和倍美克珠单抗）、抗 TNF 药物（阿达木单抗、依那西普、certolizumab 和英夫利昔单抗）、抗 IL12/23 药物（乌司奴单抗）和抗 IL23 药物（瑞莎珠单抗、古塞库单抗和替利珠单抗）。通过对长期银屑病面积和严重程度指数（PASI）措施的网络荟萃分析进行系统文献回顾，收集疗效估计值。根据剂量建议和各国的价格计算药物成本。当有生物类似药时，使用生物类似药价格替代原研药价格。
一年后，布罗达卢单抗在法国（€20220）和德国（€26807）所有可用的生物治疗中，每治疗 100 例 PASI 应答者的成本最低。在抗 IL17 药物中，布罗达卢单抗在法国比最接近的对照药物（倍美克珠单抗，€26369）的每 100 例 PASI 应答者的成本低 23%，在德国比最接近的对照药物（依奇珠单抗，€38027）的成本低 30%。在法国和德国，布罗达卢单抗在一年后也是抗 IL17 药物中每治疗 PASI75 和 PASI90 应答者的成本最低。在法国（€23418）和德国（€38264），阿达木单抗在抗 TNF 药物中每治疗 100 例 PASI 应答者的成本最低。在抗 IL23 药物中，在法国（€20969）和德国（€26994），瑞莎珠单抗每治疗 100 例 PASI 应答者的成本最低。
在法国和德国，布罗达卢单抗在一年内是抗 IL17 类药物中最具成本效益的治疗选择，也是所有其他生物药物中最具成本效益的治疗选择，其成本较低，应答率较高。
