Biologic treatment sequences for plaque psoriasis: a cost-utility analysis based on 10 years of Dutch real-world evidence from BioCAPTURE

Klijn, S.; Reek, J.M.P.A. van den; Wetering, Gijs van de; Kolk, A. Van Der; Jong, E.M.G.J. de; Kievit, Wietske

doi:10.1111/bjd.16247

Cited by 12 publications

(12 citation statements)

References 30 publications

(29 reference statements)

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“…In our study, the probability of survival on adalimumab decreased with increasing number of different previous therapies. This was further supported by a cost-effectiveness study of biological treatment sequences in the treatment of psoriasis, proposing to start the therapy with adalimumab or ustekinumab [10]. The fact, that the number and type of previous biological therapies for psoriasis and psoriatic arthritis can influence treatment discontinuation was recently described by Yiu et al [11]; however, in their study, unlike ours, previous treatment with adalimumab was a positive predictor of drug survival.…”

Section: Discussionsupporting

confidence: 62%

Real-World Evidence From More Than 1000 Patients Treated With Adalimumab For Moderate-to-Severe Psoriasis in the Czech Republic

Kojanová

Cetkovská

Štrosová

et al. 2021

Dermatol Ther (Heidelb)

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Introduction: The study aimed to evaluate the real-world effectiveness of adalimumab as well as investigate the persistence of treatment and identify factors, which may affect it. Methods: More than 1150 patients (4363.1 patient-years) with psoriasis who had been treated with adalimumab since the start of the BIOREP registry in the Czech Republic were included in this analysis. Treatment effectiveness was defined as improvement in Psoriasis Area and Severity Index (PASI). The analysis was performed during the years 2005 and 2018. Patients were on on-label dose. Results: After 12 and 96 months of therapy, 84% and 88% of patients had a 75% reduction in PASI score from baseline, respectively. Drug survival was analyzed according to the number of previous biological therapies, and results showed 75% and 58.1% survival rate for biologically naïve patients in the 20th and 80th month of treatment, respectively. The negative predictors of adalimumab survival were the female gender, obesity, baseline PASI score and the number of previous biological therapies. Conclusions: Baseline factors including PASI, number of previous biological therapies, and sex were associated with shorter adalimumab survival. This long-term study shows that adalimumab is effective and has high treatment persistence.

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Section: Discussionsupporting

confidence: 62%

Real-World Evidence From More Than 1000 Patients Treated With Adalimumab For Moderate-to-Severe Psoriasis in the Czech Republic

Kojanová

Cetkovská

Štrosová

et al. 2021

Dermatol Ther (Heidelb)

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“…For instance, head-to-head trial-based comparisons of cost-effectiveness and efficacy are important to guide practice, but these should also be supplemented with evaluations of real-world data, as demonstrated by Klijn et al in the Dutch BioCAPTURE study. 7 In the BioCAPTURE study the estimated cost and effect differences among six consecutive lines of biological treatments (with etanercept, adalimumab and ustekinumab) over a 10-year time horizon were marginal and remained without statistical significance in this analysis. Indeed, the maximum differences in costs (€141 962-148 442) and associated quality-adjusted life-years (QALYs) (7Á79-8Á03) were both < 5% (4Á6% and 3Á1%, respectively).…”

mentioning

confidence: 94%

“…Treatment decisions ultimately fall to the clinician, who must also factor in patient history and preference. 7 Polistena et al 12 found that adopting a societal perspective (taking account of additional costs and benefits associated with lost productivity, caregiver assistance and health-related quality of life) reduced the estimated cost per QALY for biological treatments by 35%. Furthermore, they found that nonmedical and indirect costs decreased by almost 72% after biological treatment.…”

mentioning

confidence: 99%

“…For instance, head‐to‐head trial‐based comparisons of cost‐effectiveness and efficacy are important to guide practice, but these should also be supplemented with evaluations of real‐world data, as demonstrated by Klijn et al . in the Dutch BioCAPTURE study …”

mentioning

confidence: 99%

“…Clinical outcomes are important (such as the Psoriasis Area and Severity Index); however, plaque psoriasis affects many aspects of patients’ health and well‐being, thus adopting a focus solely on clinical outcomes and costs may underestimate the impact of these treatments. Treatment decisions ultimately fall to the clinician, who must also factor in patient history and preference . Polistena et al .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Allocation of biologics: health economics and clinical decision making in plaque psoriasis

Bray

Wolf

2018

Br J Dermatol

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Modelling Treatment Sequences in Immunology: Optimizing Patient Outcomes

Hart,

Hassan,

Alulis

et al. 2024

Adv Ther

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Introduction For some immune-mediated disorders, despite the range of therapies available there is limited evidence on which treatment sequences are best for patients and healthcare systems. We investigated how their selection can impact outcomes in an Italian setting. Methods A 3-year state-transition treatment-sequencing model calculated potential effectiveness improvements and budget reallocation considerations associated with implementing optimal sequences in ankylosing spondylitis (AS), Crohn’s disease (CD), non-radiographic axial spondyloarthritis (NR-AxSpA), plaque psoriasis (PsO), psoriatic arthritis (PsA), rheumatoid arthritis (RA), and ulcerative colitis (UC). Sequences included three biological or disease-modifying treatments, followed by best supportive care. Disease-specific response measures were selected on the basis of clinical relevance, data availability, and data quality. Efficacy was differentiated between biologic-naïve and experienced populations, where possible, using published network meta-analyses and real-world data. All possible treatment sequences, based on reimbursement as of December 2022 in Italy (analyses’ base country), were simulated. Results Sequences with the best outcomes consistently employed the most efficacious therapies earlier in the treatment pathway. Improvements to prescribing practice are possible in all diseases; however, most notable was UC, where the per-patient 3-year average treatment failure was 37.3% higher than optimal. The results focused on the three most crowded and prevalent immunological sub-condition diseases in dermatology, rheumatology, and gastroenterology: PsO, RA, and UC, respectively. By prescribing from within the top 20% of the most efficacious sequences, the model found a 15.1% reduction in treatment failures, with a 1.59% increase in drug costs. Conclusions Prescribing more efficacious treatments earlier provides a greater opportunity to improve patient outcomes and minimizes treatment failures. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02766-w.

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Biologic treatment sequences for plaque psoriasis: a cost-utility analysis based on 10 years of Dutch real-world evidence from BioCAPTURE

Abstract: The order in which biologics are used influences treatment cost-effectiveness, both in terms of costs and health effects. Initiation of a biologic treatment sequence for psoriasis might best be done with Ada or Ust; Eta seems less optimal from a health-economic perspective.

Cited by 12 publications

References 30 publications

Real-World Evidence From More Than 1000 Patients Treated With Adalimumab For Moderate-to-Severe Psoriasis in the Czech Republic

Real-World Evidence From More Than 1000 Patients Treated With Adalimumab For Moderate-to-Severe Psoriasis in the Czech Republic

Allocation of biologics: health economics and clinical decision making in plaque psoriasis

Modelling Treatment Sequences in Immunology: Optimizing Patient Outcomes

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