Budget impact model of secukinumab for the treatment of moderate-to-severe psoriasis, psoriatic arthritis, and ankylosing spondylitis in Italy: a cross-indication initiative

Abstract

ObjectiveSecukinumab, a fully human monoclonal IgG1 antibody that selectively neutralizes the proinflammatory cytokine IL-17A, has been approved in Europe in 2015 for the treatment of adult patients with moderate-to-severe plaque psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS). This analysis assessed the budget impact of introduction of secukinumab to the Italian market for all three indications from the perspective of the Italian National Health Service.Materials and methodsA cross-indication budget impact model was developed and included biologic-treated adult patients diagnosed with psoriasis, PsA, and AS. The analyses were conducted over a 3-year time horizon and included direct costs (drug therapy costs, administration costs, diseases-related costs, and adverse events costs). Model input parameters (epidemiology, market share projections, resource use, and costs) were obtained from the published literature and other Italian sources. The robustness of the results was tested via one-way sensitivity analyses: secukinumab cost, secukinumab market share, intravenous administration costs, and adverse events costs were varied by ±10%.ResultsThe total patient population for secukinumab over the 3-year timeframe was projected to be 6,648 in the first year, increasing to 12,001 in the third year, for all three indications combined (psoriasis, PsA, and AS). Compared to a scenario without secukinumab in the market, the introduction of secukinumab in the market for the treatment of psoriasis, PsA, and AS showed a cumulative 3-year incremental budget impact of −5%, corresponding to savings of €66.1 million and per patient savings of about €1,855. The majority of the cost savings came from the adoption of secukinumab in AS (58%), followed by PsA (29%) and psoriasis (13%). Sensitivity analyses confirmed the robustness of the results.ConclusionResults from this cross-indication budget impact model show that secukinumab is a cost-saving option for the treatment of PsA, AS, and psoriasis patients in Italy.

Effectiveness and safety of secukinumab in patients with moderate-to-severe plaque psoriasis – a real life retrospective study

“…Clinical studies have labelled secukinumab, which is a humanized, monoclonal antibody anti-IL-17A, suitable as therapy for moderate to severe psoriasis, hypertrophic palmoplantaris psoriasis, and generalized pustular psoriasis in adult patients, in cases of prior failure to systemic therapies, contraindications, or intolerability to systemic agents. Also psoriatic arthritis and ankylosing spondylitis not responding to systemic agents or moderate-to-severe disease in adult patients are indications for secukinumab [15,16,[24][25][26]. Its clinical efficacy in psoriasis and safety have been well demonstrated in many clinical trials.…”

Secukinumab: A Review in Ankylosing Spondylitis

“…Chronic, immune-mediated, inflammatory diseases such as psoriasis, psoriatic arthritis and AS are associated with substantial healthcare costs [ 49 ]. In the NICE guidance, secukinumab was reported to be a cost-effective use of health system resources for AS, regardless of previous TNF inhibitor use [ 44 ].…”

“…Indeed, a modelled pharmacoeconomic study from a UK National Health Service perspective suggests that secukinumab is a cost-effective treatment option for biologic-naive and -experienced patients with active AS [ 50 ]. Model-based budget impact analyses in Italy [ 49 ], Finland [ 51 ], Greece [ 52 ] and Brazil [ 53 ] also demonstrated that secukinumab is a cost-saving option for the treatment of AS. In cost-effectiveness analyses in Portugal [ 54 ], Tunisia [ 55 ] and Korea [ 56 ], the costs per responder were lower with secukinumab than with adalimumab in patients with AS.…”

Real‐world evidence of biologic treatments in moderate–severe psoriasis in Italy: Results of the CANOVA ( EffeCtiveness of biologic treAtmeNts for plaque psOriasis in Italy: An obserVAtional longitudinal study of real‐life clinical practice) study

“…Among study biologic drugs, secukinumab was the most frequently used, followed by ustekinumab, TNF‐inhibitors, and ixekizumab, a ranking that roughly corresponds to the prescription trends for moderate–severe plaque psoriasis in Italy 35 . In any case, the range of currently available biological treatments for moderate–severe plaque psoriasis was represented.…”

“…a trends for moderate-severe plaque psoriasis in Italy. 35 In any case, the range of currently available biological treatments for moderatesevere plaque psoriasis was represented. Topical treatments and conventional systemic medications for psoriasis were ongoing in 35% and 8% of patients, respectively.…”