WHAT IS THE CADTH REIMBURSEMENT RECOMMENDATION FOR BIMZELX?: CADTH recommends that Bimzelx should be reimbursed by public drug plans for the treatment of moderate to severe plaque psoriasis if certain conditions are met. WHICH PATIENTS ARE ELIGIBLE FOR COVERAGE? Bimzelx should be covered to treat adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy, provided that Bimzelx is covered in a similar way to other interleukin-17 inhibitors currently reimbursed by public drug plans for the treatment of adult patients with moderate to severe plaque psoriasis. WHAT ARE THE CONDITIONS FOR REIMBURSEMENT? Bimzelx should only be reimbursed if prescribed by a dermatologist and the cost of Bimzelx is reduced. WHY DID CADTH MAKE THIS RECOMMENDATION? Evidence from 4 clinical trials demonstrated that Bimzelx improves skin clearance compared with treatment with placebo and 3 other biologics: adalimumab, ustekinumab, and secukinumab. Bimzelx may meet some of the needs that are important to patients, including clearing plaques. There was uncertainty regarding the long-term safety and effectiveness of Bimzelx compared with other biologics for psoriasis because of the short duration of the clinical trials and other limitations in the evidence. Based on CADTH’s assessment of the health economic evidence, Bimzelx does not represent good value to the health care system at the public list price and requires a price reduction of at least 41%. Based on public list prices, the 3-year budget impact of Bimzelx could not be determined due to limitations with the sponsor’s budget impact analysis that could not be addressed by CADTH. The sponsor estimated a 3-year budget impact of $20 million.
WHAT IS PLAQUE PSORIASIS? Plaque psoriasis is a skin disease that causes red, flaky, crusty patches of skin that may be itchy and painful and can lead to negative impacts on social and work life. Up to 1 million people living in Canada are living with psoriasis, a third of whom have moderate to severe disease. UNMET NEEDS IN PLAQUE PSORIASIS: Although many treatments are approved in Canada to treat moderate to severe plaque psoriasis, some patients may not respond to these treatments. Other treatment options are needed for these patients. HOW MUCH DOES BIMZELX COST? Treatment with Bimzelx is expected to cost approximately $30,631 per patient in year 1 and $22,921 per patient in subsequent years based on the assumption that 8.5% of patients had a body weight of 120 kg or more and would receive dosing every 4 weeks.
