Cost and Cost Effectiveness of Treatments for Psoriatic Arthritis: A Systematic Literature Review

D’Angiolella, Lucia Sara; Cortesi, P.A.; Lafranconi, Alessandra; Micale, Mariangela; Mangano, Sveva; Cesana, Giancarlo; Mantovani, Lorenzo Giovanni

doi:10.1007/s40273-018-0618-5

Cited by 47 publications

(38 citation statements)

References 29 publications

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“…PsA is characterised by pain, stiffness, swollen joints, joint erosion and bone formation, and psoriasis is a common concomitant condition 1 2. PsA is also associated with reduced quality of life and substantial healthcare resource use and costs 3 4…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of biologics in psoriatic arthritis: a systematic literature review and network meta-analysis

Ruyssen‐Witrand

Perry

Watkins³

et al. 2020

RMD Open

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BackgroundBiologic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs are used in patients with psoriatic arthritis (PsA), but few studies directly compare their clinical efficacy. In such situations, network meta-analysis (NMA) can inform evidence-based decision-making.ObjectiveTo evaluate the comparative efficacy and safety of approved bDMARDs in patients with PsA.MethodsBayesian NMA was conducted to compare the clinical efficacy of bDMARDs at weeks 12‒16 in bDMARD-naïve patients with PsA in terms of American College of Rheumatology (ACR) criteria, Psoriatic Arthritis Response Criteria (PsARC) and Psoriasis Area and Severity Index (PASI). Safety end points were evaluated in the overall mixed population of bDMARD-naive and bDMARD-experienced patients.ResultsFor ACR, all treatments except abatacept were statistically superior to placebo. Infliximab was most effective, followed by golimumab and etanercept, which were statistically superior to most other treatments. Ixekizumab 80 mg every 2 weeks (Q2W) was statistically superior to abatacept subcutaneous, apremilast and both regimens of ustekinumab; similar findings were observed for ixekizumab 80 mg Q4W. For PsARC response, ixekizumab did not significantly differ from other therapies, except for golimumab, infliximab and etanercept, which were superior to most other agents including ixekizumab. For PASI response, infliximab was numerically most effective, but was not statistically superior to ixekizumab, which was the next best performing agent. Analysis of safety end points identified few differences between treatments.ConclusionOur NMA confirms the efficacy and acceptable safety profile of bDMARDs in patients with active PsA. There were generally few statistically significant differences between most treatments.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of biologics in psoriatic arthritis: a systematic literature review and network meta-analysis

Ruyssen‐Witrand

Perry

Watkins³

et al. 2020

RMD Open

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“…Patients with PsA also experience fatigue and work productivity loss [6], as well as common comorbidities such as cardiovascular disease, obesity, diabetes, depression, and anxiety [4,6,7], which can contribute to both disease and economic burden [8]. Estimates of the direct annual healthcare costs related to PsA from a recent claimsbased analysis and systematic reviews have ranged widely from $3693 to $26,883 per patient; however, studies varied by year, country of study, payer type, severity of PsA, and costing methodology [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis

Pelletier²,

Ung³

et al. 2020

Adv Ther

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Introduction: We compared treatment switch patterns and healthcare costs among biologicnaive patients with psoriatic arthritis (PsA) who initiated apremilast or biologics. Methods: A 1:2 propensity score match was used to adjust administrative claims data for adults initiating apremilast or biologics from January 1, 2014, to September 30, 2016, for possible selection bias. Patients had at least 12 months of pre-and post-index continuous enrollment in the Optum Clinformatics TM Data Mart database. Outcomes included switch frequency, days to switch, adherence on index treatment, and healthcare costs (total and per patient per month). Switch rate was defined as the proportion of patients who switched to a new treatment after initiation of the index Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11830302.

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“…Several health economic analyses have been conducted in the treatment of PsA, as highlighted in a recent systematic review [6], and findings of two recent analyses are noteworthy. A Canadian CEA reported that secukinumab either dominated or was cost-effective when compared with all other licensed bDMARDs in treating active PsA in bDMARD-naïve and -experienced populations [45].…”

Section: Discussionmentioning

confidence: 99%

“…PsA commonly coexists with psoriasis [1,2]. In particular, moderate-to-severe PsA is associated with reduced health-related quality of life and substantial healthcare resource use and costs [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Several biologic disease-modifying antirheumatic drugs (bDMARDs) are approved for treating patients with PsA. bDMARDs are major drivers of total costs in the management of PsA [6,8]; for example, they accounted for approximately 70% of the total direct cost of PsA in a large US cohort [8]. The use of bDMARDs in the UK is under increasing scrutiny, especially given the advent of biosimilars and the growing number of biologic agents.…”

Section: Introductionmentioning

confidence: 99%

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Cost-Effectiveness Analysis of Sequential Biologic Therapy with Ixekizumab Versus Secukinumab in the Treatment of Active Psoriatic Arthritis with Concomitant Moderate-to-Severe Psoriasis in the UK

Schweikert¹,

Malmberg²,

Åkerborg

et al. 2020

PharmacoEconomics Open

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Background Interleukin-17A (IL-17A) antagonists are a recent innovation for treating psoriatic arthritis (PsA). There are currently no cost-effectiveness analyses (CEAs) comparing the IL-17A antagonists ixekizumab and secukinumab in PsA from a UK perspective. Objective We conducted a CEA from the UK National Health Service perspective to compare ixekizumab versus secukinumab in patients with PsA and concomitant moderate-to-severe plaque psoriasis. Methods A Markov model was developed based on the widely accepted York model. In biologic disease-modifying antirheumatic drug (bDMARD)-naïve patients, ixekizumab → ustekinumab → best supportive care (BSC) was compared with secukinumab → ustekinumab → BSC. For bDMARD-experienced patients, ixekizumab → BSC was compared with secukinumab → BSC. At the end of the bDMARD trial period, Psoriatic Arthritis Response Criteria (PsARC) responders continued to receive the bDMARD in the continuous treatment period. PsARC nonresponders and patients who ceased continuous treatment transitioned to the trial period of the next treatment. Results Ixekizumab was less costly and provided more quality-adjusted life-years (QALYs) than secukinumab in bDMARDnaïve and-experienced patients based on list prices, although cost savings and QALY gains were small to modest. In bDMARD-naïve patients, total costs were £155,455 compared with £155,530 for secukinumab (year 2017 values). Total QALYs were 8.127 versus 7.989. In bDMARD-experienced patients, the corresponding values were £140,051 versus £140,264 for total costs and 3.996 versus 3.875 for total QALYs. Conclusion Ixekizumab provided more QALYs at a marginally lower cost than secukinumab, and the results were most sensitive to changes in drug costs. Other factors, such as patient preferences for the number of injections and confidential price discounts, may be important considerations in clinical decision-making.

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Cost and Cost Effectiveness of Treatments for Psoriatic Arthritis: A Systematic Literature Review

Cited by 47 publications

References 29 publications

Efficacy and safety of biologics in psoriatic arthritis: a systematic literature review and network meta-analysis

Efficacy and safety of biologics in psoriatic arthritis: a systematic literature review and network meta-analysis

Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis

Cost-Effectiveness Analysis of Sequential Biologic Therapy with Ixekizumab Versus Secukinumab in the Treatment of Active Psoriatic Arthritis with Concomitant Moderate-to-Severe Psoriasis in the UK

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