Economic evaluation of etanercept in the management of chronic plaque psoriasis

Abstract

This model found the licensed dose regimen of etanercept 50 mg biw to be cost effective in the U.K. This regimen was particularly appropriate for patients with severe disease or poor quality of life at baseline.

Cost-effectiveness of treatment with etanercept for psoriasis in Sweden

“…Other studies have modeled etanercept treatment in psoriasis [25,[46][47][48]. The York model previously mentioned estimated an ICER for intermittent etanercept 25 mg twice daily of £14,460 (approximately €21,690) compared with non-systemic standard of care.…”

“…Following British guidelines, the York model excluded indirect costs. The results of a UK-based economic model comparing etanercept 50 mg twice weekly with non-systemic therapy found the ICER to be £6,217 over a 10 years time horizon [46]. Again this model excluded patients with moderate disease and indirect costs.…”

Systematic Review of Cost-Effectiveness Analyses of Treatments for Psoriasis

“…The values or changes in utility were measured by levels of PASI response in five studies [24,40,51,53,62]. Three studies mapped the Dermatology Life Quality Index (DLQI) to European Quality of Life-5 Dimensions (EQ-5D) utilities [35,57,59]; however, Woolacott et al [67] mapped the change in DLQI associated with different PASI response categories and baseline DLQI scores to changes in EQ-5D utility. The remaining studies either estimated utility values directly from study patients [22,26,58], stated utility values from previous studies were used without providing further details [43,56], or obtained utilities by response status defined by neither PASI nor DLQI from previous studies [60].…”

“…Over 90 % of the studies reported objectives (item 1), sources of variable estimates (item 3), methodology of data abstraction (item 7), primary outcome measures (items 10 and 11), and choice of economic model (item 13) ( Table 1). Only five studies conducted a subgroup analysis (item 4), either based on the patients with different disease severity levels at baseline [43,56,59,67] or among patients who completed the study [65]. Approximately 40 % of the studies only estimated the cost-effectiveness ratios (e.g.…”

“…Different assumptions that have an impact on the costs or outcomes were also considered in the sensitivity analysis. The main assumptions include patient compliance or adherence to treatments [49,60], length of treatment [31], productivity costs [58,62], hospitalization for non-responders [24,62,67], defining responders by PASI 90 (a 90 % reduction in the PASI score) [32] or PASI 50 (a 50 % reduction) [62] instead of PASI 75 (a 75 % reduction), a treatment-free response period [21], responding patients withdrawing from treatment [35,40], reduced response upon re-treatment [59], and disutility on intermittent therapy [62]. Furthermore, more than one time horizon was applied in some studies [23,32,35,40,46,48,60,71].…”