Cost‐efficacy of adalimumab, etanercept, infliximab and ustekinumab for moderate‐to‐severe plaque psoriasis

Ferrándiz, Carlos; García, A Calvo; Blasco, Antonio Javier; Lázaro, Pablo

doi:10.1111/j.1468-3083.2011.04357.x

Cited by 32 publications

(43 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of studies sourced drug efficacy mainly from clinical trials conducted on one of the three anti-TNF-α antagonists, [11][12][13][14][15]17] only one from a patients' registry. [16] Two studies on Ps [11,15] included all health-care costs except those due to adverse events, two [12,14] limited their analysis to the outpatient costs, the remainder [13] to drugs only; the two studies on RA [16,17] included all health-care costs, one of them [16] the direct non-health-care costs too.…”

Section: Economic Evaluations In the Eumentioning

confidence: 99%

“…1 Five of the seven studies finally selected focused on Ps, [11][12][13][14][15] two on RA [16,17] ( Table 2). How the alternatives were evaluated varied a lot in Ps: three studies compared the three anti-TNF-α antagonists against placebo [13,14] or supportive care, [15] one directly with each other, [12] the last only ADA with ETN. [11] In the two RA studies, ADA, ETN and IFL-alone [16] or in co-therapy with methotrexate [16,17]-were compared with traditional antirheumatic drugs.…”

Section: Economic Evaluations In the Eumentioning

confidence: 99%

“…[11] In the two RA studies, ADA, ETN and IFL-alone [16] or in co-therapy with methotrexate [16,17]-were compared with traditional antirheumatic drugs. Three studies on Ps included a cost-effectiveness analysis, [12][13][14] the two on RA [16,17] and one more on Ps [11] a cost-utility, the remainder on Ps both techniques. [15] Five studies took a third-party payer's viewpoint, [12][13][14][15]17] the other two a societal perspective.…”

Section: Economic Evaluations In the Eumentioning

confidence: 99%

“…Three studies on Ps included a cost-effectiveness analysis, [12][13][14] the two on RA [16,17] and one more on Ps [11] a cost-utility, the remainder on Ps both techniques. [15] Five studies took a third-party payer's viewpoint, [12][13][14][15]17] the other two a societal perspective. [11,16] The two studies on RA [16,17] and the most recent on Ps [11] adopted long-term Markov models; three studies on Ps short-term horizons (max.…”

Section: Economic Evaluations In the Eumentioning

confidence: 99%

“…[11,16] The two studies on RA [16,17] and the most recent on Ps [11] adopted long-term Markov models; three studies on Ps short-term horizons (max. 48 weeks) based on "decision trees" [12][13][14] referred to the clinical trials from which they sourced efficacy; the remaining study on Ps [15] was based on a Markov model and adopted an unclear "average year" derived from a mix of trials.…”

Section: Economic Evaluations In the Eumentioning

confidence: 99%

See 4 more Smart Citations

Older anti-TNF-αagents: why not group them for common indications in the EU?

Garattini

Ghislandi

2016

Expert Review of Pharmacoeconomics & Outcomes Research

View full text Add to dashboard Cite

Section: Economic Evaluations In the Eumentioning

confidence: 99%

Section: Economic Evaluations In the Eumentioning

confidence: 99%

Section: Economic Evaluations In the Eumentioning

confidence: 99%

Section: Economic Evaluations In the Eumentioning

confidence: 99%

Section: Economic Evaluations In the Eumentioning

confidence: 99%

See 3 more Smart Citations

Older anti-TNF-αagents: why not group them for common indications in the EU?

Garattini

Ghislandi

2016

Expert Review of Pharmacoeconomics & Outcomes Research

View full text Add to dashboard Cite

Cost-effectiveness of systemic treatments for moderate-to-severe psoriasis in the German health care setting

et al. 2016

View full text Add to dashboard Cite

Systemic treatments of moderate-to-severe psoriasis differ substantially in terms of effectiveness and costs. Comprehensive economic-evaluations of all systemic treatments for psoriasis from a societal perspective are missing. The objective of our study was to compare the cost-effectiveness all systemic treatments approved for moderate-to-severe psoriasis from a societal perspective, by including all cost categories. An incremental cost-effectiveness-analysis was performed for all systemic treatments for psoriasis, currently recommended by the German S3-Guideline i.e. methotrexate, cyclosporine, fumaric acid esters, and retinoids, adalimumab, etanercept, infliximab and ustekinumab. We used a Markov model with time-dependent transition probabilities and a time horizon of 2 years to investigate incremental cost-effectiveness ratios. Both direct and indirect costs were considered to reflect the societal perspective. Effectiveness outcome was PASI-75 response. One-way and probabilistic sensitivity analyses explored the effect of treatment duration, discount rate, effectiveness, and the perspective (societal vs. healthcare system) on the findings. According to the base-case analysis a cost-effective treatment pathway for moderate-to-severe psoriasis starts with methotrexate, followed by ustekinumab 90 mg and infliximab, if methotrexate does not achieve or maintain PASI-75 response. Sensitivity analyses confirmed the general robustness of these findings with methotrexate being most cost-effective. However, from a third-party-payer perspective (without indirect cost) conventional therapies were generally more cost-effective than biologics. From a value-based healthcare perspective, methotrexate should be the systemic treatment of first choice, ustekinumab 90 mg second choice and infliximab third choice for patients with moderate-to-severe psoriasis. From a societal perspective, the other treatments are less efficient according to our model. From a third-party-payer perspective conventional therapies are more cost-effective than biologics.

show abstract

Health economic analyses of psoriasis management: a systematic literature search

Gutknecht

Augustin

2016

Arch Dermatol Res

View full text Add to dashboard Cite

In the course of the chronic skin disease psoriasis, where a variety of treatment interventions is available, a strong growth of health economic studies comparing treatment costs and benefits can be noticed. The objective was to identify health economic evaluations of psoriasis treatments that have been published to date. Of particular interest were the mostly used analysis and outcome parameters, the compared treatments, and the question, if available health economic studies may be used to perform a meta-analysis of qualitative findings. A systematic literature search using PubMed Medline, Ovid Medline, and Cochrane Library was performed for articles, published and available until mid of January 2016. Among the key words were the terms "psoriasis" and "cost-effectiveness". The search resulted in 318 articles without duplicates. Thereof 60 health economic analyses in psoriasis management were identified. Most of these are cost-effectiveness evaluations (45). The clinical parameter PASI (Psoriasis Area Severity Index) is the most often used cost-effectiveness outcome (33) followed by the Dermatology Life Quality Index (DLQI) (6). In case of cost-utility analyses, QALYs (quality-adjusted life-years) were mostly generated with the help of EuroQol five dimensions questionnaire (EQ-5D) (12), which was partly based on PASI and DLQI values. The majority of health economic studies is focusing on the direct medical and non-medical costs without consideration of productivity losses. Almost 70 % of 60 publications were conducted in Europe. Overall, most considered systemic treatments were the biological agents etanercept (36), adalimumab (27), and infliximab (26) followed by ustekinumab (17) and phototherapy (incl. UV-B, PUVA/psoralen combined with UV-A) (14). Comparisons including only topical treatments mostly focused on vitamin D treatment (14), corticosteroids (13), and coal tar products (6) followed by dithranol (5) and tazarotene (4). Given the setting, compared treatments, and study conditions, different results can be found for medical decision-making. Thereby, it can be noted that there are no standards on methods and outcomes measures available. This leads to a very limited comparability of health economic studies and presents no comfortable basis to examine a meta-analysis of health economic results. The presented systematic review shows the need for nationwide data and interpretation.

show abstract

Cost‐efficacy of adalimumab, etanercept, infliximab and ustekinumab for moderate‐to‐severe plaque psoriasis

Abstract: In terms of cost-efficacy, the most efficient biological drug was adalimumab. The robustness of this finding was confirmed by sensitivity analysis.

Cited by 32 publications

References 26 publications

Older anti-TNF-αagents: why not group them for common indications in the EU?

Older anti-TNF-αagents: why not group them for common indications in the EU?

Cost-effectiveness of systemic treatments for moderate-to-severe psoriasis in the German health care setting

Health economic analyses of psoriasis management: a systematic literature search

Contact Info

Product

Resources

About