Abstract

To investigate the budgetary impact of adopting certolizumab pegol (CZP) for the recently indicated treatment of moderate to severe plaque psoriasis in Greece. A 5-year (2018–2022) budget impact model was developed and used from a public payer perspective to delineate the financial implications of introducing CZP for the treatment of moderate to severe plaque psoriasis, alongside other marketed biologics (adalimumab, etanercept, infliximab, ustekinumab, and secukinumab) and apremilast. The model considered market share scenarios with/without CZP (200mg [90%] and 400mg [10%]), and directly reimbursed costs of treatment and disease management, applied to the prevalent and eligible Greek patient population. Quarterly treatment discontinuation was geared to enable tracking of patients, so that the model could apply different costs to patients at different stages of treatment. Costs pertaining to drug acquisition, administration, and monitoring were included for both the induction and maintenance years of patients’ treatment. Resource use, unit costs and epidemiological data were retrieved from officially published sources and a local clinical expert. Outcomes were incremental costs per treated patient per year (PTPPY) and total budgetary impact, calculated by comparing the respective patient-level and total budget expenditures with and without CZP in the market share mix scenarios. The total and PTPPY savings resulting from the addition of CZP to the original treatment mix were estimated at €2,141,771 (-0.40%) and €188, respectively, over 5 years. On average, annual total/PTPPY savings of €428,354 (-0.40%) and €38 were calculated. Over time, the gradual increase in CZP market share was associated with greater cost savings for the public payer, ending with the highest total savings (€742,050 [-0.70%]) by 2022 (CZP share: 4.1%). These savings were mainly driven by reduced drug and administration costs. The inclusion of CZP for psoriasis treatment was predicted to be associated with cost savings in Greece.

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