Cost-Utility Analysis of Apremilast for The Treatment of Moderate to Severe Psoriasis In Spain

Abstract

IVT-AFL 2q8 versus ranibizumab 0.5q4, and an indirect comparison of IVT-AFL 2q8 with ranibizumab 0.5PRN data. A de novo health economic model combined these clinical inputs with Dutch-specific costs associated with treatment, monitoring, and indirect caregiving, and utility inputs relevant to a Dutch population. Total quality-adjusted life-years (QALYs) and costs were calculated over a 15-year horizon. Uncertainty around the outcomes was tested through sensitivity analyses. Results: Compared with ranibizumab 0.5q4, a 2-year treatment IVT-AFL is associated with a significantly lower cost of € 7337 (95% CI: € 7248-€ 7435) over a 15-year horizon. There is no significant difference in QALYs (-0.0027 [95% CI: -0.0057 to 0.0001]). IVT-AFL 2q8 also has significantly lower total costs than ranibizumab 0.5PRN (€ 2450 [95% CI: € 2349-€ 2549]), with a nonsignificant gain of 0.0007 QALYS (95% CI: -0.0023 to 0.0036). Probabilistic analyses show that, due to its lower costs, IVT-AFL 2q8 treatment had an estimated > 99% probability of being cost-effective compared with both of the ranibizumab treatment strategies at a willingness-to-pay threshold of € 20,000 per QALY, the proposed informal Dutch threshold. The univariate analyses did not alter the conclusions. ConClusions: The analysis showed that IVT-AFL 2q8 treatment is associated with cost savings versus ranibizumab 0.5q4 or 0.5PRN. There is no significant difference in total QALYs between the treatments. Due to lower overall costs, IVT-AFL is a costeffective treatment option for wAMD patients in the Netherlands.

Biologicals and small molecules in psoriasis: A systematic review of economic evaluations

“…For 15 of the 53 studies included, only an abstract or a poster could be retrieved, leading to lower quality data due to limited information [ 31 , 33 , 35 , 38 , 39 , 43 – 47 , 54 , 57 , 62 , 77 , 80 ].…”

“…All studies provided a research question; however, the viewpoint of the analyses was stated clearly in only 77% [ 28 , 29 , 32 – 35 , 37 – 39 , 41 – 52 , 54 – 57 , 59 , 61 , 62 , 64 – 66 , 70 – 76 , 78 – 80 ]. A total of 47 studies reported the source of effectiveness estimates [ 28 – 42 , 48 – 79 ], and in nearly two-thirds of them, further information on methods of synthesis (if based on multiple studies) or design and result (if based on a single study) was provided [ 28 , 30 , 31 , 33 – 36 , 38 , 40 , 48 , 52 , 54 , 55 , 58 – 60 , 63 – 66 , 69 – 74 , 78 , 79 ].…”

“…A total of 47 studies reported the source of effectiveness estimates [ 28 – 42 , 48 – 79 ], and in nearly two-thirds of them, further information on methods of synthesis (if based on multiple studies) or design and result (if based on a single study) was provided [ 28 , 30 , 31 , 33 – 36 , 38 , 40 , 48 , 52 , 54 , 55 , 58 – 60 , 63 – 66 , 69 – 74 , 78 , 79 ]. Even though price data was always recorded, only 31 studies reported quantities of resources and unit costs separately [ 28 , 29 , 32 , 34 , 35 , 38 , 40 – 42 , 48 – 50 , 52 – 55 , 59 – 62 , 64 – 67 , 70 – 73 , 75 , 76 , 78 ]. Nearly all studies stated the time horizon of analysis [ 28 , 30 , 31 , 33 – 52 , 54 – 72 ...…”

“…Nearly all studies stated the time horizon of analysis [ 28 , 30 , 31 , 33 – 52 , 54 – 72 , 74 – 80 ]. 43% did not report statistical tests or confidence intervals [ 29 , 32 , 35 , 37 – 41 , 43 – 47 , 49 – 51 , 57 , 61 , 63 , 66 , 67 , 75 , 80 ]. Sensitivity analysis was clearly recorded in 42 studies [ 28 , 30 , 32 – 37 , 39 , 41 – 49 , 51 , 52 , 54 – 57 , 59 – 62 , 64 – 66 , 68 – 70 , 72 – 74 , 76 – 80 ].…”

“…QALYs were derived from mapping EQ-5D (European Quality of life in 5 Dimensions, a pre-scored multi-attribute questionnaire to measure health-related quality of life) with PASI or DLQI (n = 9) [ 30 , 51 , 54 , 55 , 59 , 65 , 73 , 74 , 77 ]. National weights were applied in four studies to calculate QALYs [ 33 , 35 , 39 , 62 ]. Time trade-off was used in two studies [ 37 , 78 ].…”