The aim of this study is evaluation of incremental costs, incremental health benefits and the incremental ratio (ICER) of biologic drug therapies used for treatment of plaque psoriasis (PP) in Bulgaria by transferring and adapting data from health technology assessments, conducted in other countries. MethOds: We conducted a systematic review of published data from health technology assessments used for treatment of PP. We used the following databases -MEDLINE, EMBASE, Web of science, Cochrane Library. Publications search covered the period January 2006 -December 2015. Results: The adapted economic results in Bulgaria showed that SEC is cost-effective therapy, compared to all other biologic drug alternatives for treatment of PP -secukinumab is superior to ustekinumab, secukinumab vs. infliximab (ICER 3173 BGN/QALY), secukinumab vs. adalimumab, (ICER 5657 BGN/ QALY), secukinumab vs. etanercept (ICER 17 BGN/QALY), if we consider a costeffectiveness threshold of three times GDP per capita in Bulgaria (WTPth 36 221 BGN, 2015). cOnclusiOns: The analysis and evaluation of the alternative biologic therapies used for treatment of plaque psoriasis in Bulgaria showed that, based on the HTA analysis secukinumab could be recommended as a first choice in third therapeutic line in adults with moderate to severe PP (PASI ≥ 12, IGAmod 2011 -3/4, BSA ≥ 10%) after failure of local therapy, phototherapy and conventional systemic therapy (cyclosporine, methotrexate, acitretin).

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