PSS15 Economic Analysis of Etanercept as Continuous or Paused Therapy in Moderate to Severe Psoriasis from a Public Perspective in Colombia

Abstract

retreatment regimens, which allows continuous or paused therapeutic schemes. This study aims to perform cost-effectiveness and cost-utility analyses of biologic alternatives for moderate to severe psoriasis in Venezuela, from a public payer=s perspective. METHODS: A decision-tree model simulates psoriasis evolution after treatment with etanercept continuous (50mg twice a week for 12 weeks, followed by 25mg twice a week) or paused (12-week treatment cycle and 12-week interruption), adalimumab (80mg at first week, followed by 40mg in the second week, then 40mg every 2 weeks), infliximab (5 mg/kg at weeks 0, 2 and 6, then every 8 weeks) or ustekinumab (45mg in weeks 0 and 4, then 45mg every 12 weeks) and their associated costs in a 96-week time horizon. Therapy continuation or switch was evaluated at week 24. Effectiveness measures were PASI 75 success rate and quality adjusted life years (QALY) gained. Costs included biologicals, medical follow-up and adverse events management, from Venezuela official databases (values represented 2010 USD). Probabilistic sensitivity analyses were performed through Monte Carlo simulation. A 5% discount rate was applied for costs and benefits. RESULTS: Effectiveness resulted in [

Treatment Sequencing After Failure of the First Biologic in Cost-Effectiveness Models of Psoriasis: A Systematic Review of Published Models and Clinical Practice Guidelines

“…In 10 of the 25 models reviewed, treatment sequencing with an active treatment after failure of the first-line biologic was explicitly included in the analysis [ 10 , 11 , 15 – 19 , 21 , 33 , 34 ]. The time horizons for the cost-effectiveness analyses in these models ranged from 96 weeks to 10 years.…”

“…The time horizons for the cost-effectiveness analyses in these models ranged from 96 weeks to 10 years. Five of the ten models that included an active treatment after failure of the first-line biologic were available only as abstracts and did not provide details of the treatment switches that were included [ 15 – 19 ]. These models included cost-effectiveness estimates for Colombia, Brazil (private and public perspective), Venezuela and Argentina; all were based on the same model structure and had a time horizon of 96 weeks.…”