A Cost Per Responder Analysis of Secukinumab Vs. Adalimumab Based on a Matching-Adjusted Indirect Comparison of Efficacy Data for the Treatmetn of Psoriatic Arthritis at 48 Weeks from the Irish Payer Perspective

Abstract

The objective of this analysis was to estimate and compare the cost per responder (CPR) in Ireland, based on the American College of Rheumatology (ACR) outcomes following 48 weeks of treatment for psoriatic arthritis (PsA) with the fully human anti-IL-17A antibody secukinumab (SEC) relative to the anti-TNF antibody adalimumab (ADA). Results from a previous matching-adjusted indirect comparison (MAIC) based on FUTURE 2 and ADEPT RCTs was used to calculate the CPR for each treatment. Drug costs were estimated based on cost to the national Irish payer (including VAT, rebates and wholesaler margins) and the number of doses required for 48 weeks. Other cost domains like administration or high tech patient care fees were not included as this was considered to be equal for both treatments. The MAIC analysis showed that ACR 20/50/70 response rates, which are key outcomes to determine improvement in PsA, were higher for SEC compared to ADA in biologic-naïve PsA patients. ACR 20/50/70 response rates were 80% /57% /32%; 74% /61% /43%; and 56% /44% /30% for SEC 150mg, SEC 300mg and ADA respectively. Cost per ACR20 responders were EUR 13,147, EUR 29,092 and EUR 27,674; cost per ACR 50 responders were EUR 18,320, EUR 34,831 and EUR 35,640; and cost per ACR70 responders were EUR 32,347, EUR 49,867 and EUR 52,273 for SEC 150mg, SEC 300mg and ADA respectively. Sensitivity analyses showed similar results and confirmed the robustness of the results. The 48 week CPR for all ACR 20/50/70 response rates were lower for SEC 150mg compared to ADA. These findings indicate that SEC 150mg dominates ADA by providing higher outcomes to lower cost for biologic-naïve PsA patients in Ireland.