Godding Linda T H, Seyger Marieke M B, Duvetorp Albert, Otero Marisol E, Ossenkoppele Paul M, Oostveen Annet M, Visch M Birgitte, Van der Voort Ella A M, Körver John E M, Weppner-Parren Lizelotte J M T, Berends Maartje A M, Arnold W Peter, Dodemont Sharon R P, Kuijpers Astrid L A, Mommers Johannes M, Homan Femke M, Gostynski Antoni H, Velstra Berit, Kleinpenning Marloes M, Van Doorn Martijn B A, Keijsers Romy R M C, Kop Else N, Haeck Inge M, Hendricksen-Roelofzen Judith H J, Vellinga Douwe, De Jong Elke M G J, Van den Reek Juul M P A
Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Leo Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Department of Dermatology Malmö, Skåne University Hospital, Region Skåne, Malmö, Sweden.
Acta Derm Venereol. 2025 Jun 18;105:adv42767. doi: 10.2340/actadv.v105.42767.
Although biologics have revolutionized psoriasis treatment, they pose a significant burden on the healthcare budget. With the wide range of biologics available and the increasing number of biosimilars, insights into the real-world cost per responder (CPR) are required. Therefore, this study aims to evaluate the real-world CPR of adalimumab, ustekinumab, IL17- and IL23-inhibitors, incorporating both relative (Psoriasis Area and Severity Index; PASI75/90/100) and absolute (PASI ≤ 3/ ≤ 1) responder definitions and real-world dose adjustments. Tildrakizumab and bimekizumab were excluded due to limited data. Using Dutch list prices and discounts on adalimumab's and ustekinumab's originator prices because of biosimilar availability, adalimumab showed the lowest 1-year CPR across all responder definitions. Among biologics without biosimilar availability, the lowest CPRs were seen for brodalumab and guselkumab. Overall, the cost-per-PASI ≤ 3-responder was, across all biologics, more homogeneous than the CPR based on relative PASIs. Similar patterns were seen when using Swedish prices, which are, in contrast to Dutch prices, transparent. The relevance of using real-world data, specifically with the use of absolute PASIs instead of relative PASIs, is shown in this study. Additionally, as price fluctuations have the biggest impact on cost-effectiveness, price transparency is essential to effectively guide physicians in selecting a cost-effective treatment strategy.
尽管生物制剂彻底改变了银屑病的治疗方式，但它们给医疗保健预算带来了巨大负担。鉴于可用的生物制剂种类繁多且生物类似药数量不断增加，有必要深入了解每位缓解者的实际成本（CPR）。因此，本研究旨在评估阿达木单抗、乌司奴单抗、IL17和IL23抑制剂的实际CPR，纳入相对（银屑病面积和严重程度指数；PASI75/90/100）和绝对（PASI≤3/≤1）缓解者定义以及实际剂量调整。由于数据有限，替拉珠单抗和比美吉珠单抗被排除在外。利用荷兰的标价以及因生物类似药的可获得性而对阿达木单抗和乌司奴单抗的原研药价格给予的折扣，在所有缓解者定义中，阿达木单抗的1年CPR最低。在没有生物类似药的生物制剂中，布罗达单抗和古塞库单抗的CPR最低。总体而言，在所有生物制剂中，达到PASI≤3缓解者的成本比基于相对PASI的CPR更为一致。使用瑞典价格时也观察到了类似模式，与荷兰价格不同，瑞典价格是透明的。本研究显示了使用实际数据的相关性，特别是使用绝对PASI而非相对PASI的相关性。此外，由于价格波动对成本效益的影响最大，价格透明度对于有效指导医生选择具有成本效益的治疗策略至关重要。
