Open AccessCost-effectiveness of moderate-to-severe psoriasis biologic treatments in Brazilian private healthcare system: cost-per-responder results derived from a network metanalysis
Author(s) -
André Vicente Esteves de Carvalho,
Gleison Vieira Duarte,
Mayra Ianhez,
Bruno Leonardo Silva,
Carla de Agostino Biella,
Rafael Freitas dos Santos
Publication year - 2020
Publication title -
jornal brasileiro de economia da saúde
Language(s) - English
Resource type - Journals
eISSN - 2359-1641
pISSN - 2175-2095
DOI - 10.21115/jbes.v12.n3.p231-40
Subject(s) - medicine , cost effectiveness , number needed to treat , relative risk , confidence interval , risk analysis (engineering)
Objective: To assess the cost-per-responder (CpR) of biologic therapies available in Brazil to treat moderate-to-severe plaque psoriasis (PsO) from the private healthcare system’s perspective. Methods: Number needed to treat (NNT) and (CpR) analyses were performed to evaluate biologic therapies’ cost-effectiveness for moderate-to-severe PsO available in Brazil. The effectiveness of biologic treatments for moderate-to-severe PsO was assessed based on a previously published metanalysis, which included studies considering PsO patients and outcomes of interest (PASI 75, 90, and 100). The clinical efficacy data in terms of estimated NNT based on the network metanalysis (NMA) results were combined with drug treatment costs to determine the CpR for each treatment arm in 3-time horizons: the primary response period, 1-year, and 2-years. Results: Risankizumab was the most cost-effective option when NMA base case scenario data was used to calculate NNT in all PASI response for both the primary response period and 1- and 2-years follow-up durations. Differences in CpR between risankizumab and other biologic drugs increased with more significant PASI improvements. CpR sensitivity analysis also confirmed these findings, indicating that risankizumab has a better performance for PASI 100, and both risankizumab and guselkumab are very similar in terms of cost per additional PASI 75 and PASI 90 responder. Conclusions: Risankizumab was estimated to have a lower cost per PASI 75, 90, and 100 responders in most simulated scenarios (primary response period [12-16 weeks], 1-year and 2-years), among the evaluated biologic therapies.