PSS14 - Cost Per Responder Analysis of Guselkumab Versus Etanercept Using Efficacy Results from Pivotal Clinical Trials in Patients with Moderate to Severe Plaque Psoriasis

Abstract

To estimate the cost per responder in the United States (US) for guselkumab relative to etanercept in the induction year of treatment for patients with moderate to severe plaque psoriasis. Psoriasis Area Severity Index (PASI) 90 response rates from two pivotal clinical trials were used. Effectiveness assumptions for the induction year were based on 24 week data for guselkumab from VOYAGE 1 and 24 week data for etanercept from Leonardi et al., 2003 (high dose arm). Response rates were assumed to be unchanged from week 24 through week 52 for both drugs. Dosing was based on the FDA label in the induction year for a 52-week year (guselkumab 8 doses, etanercept 64 doses). It was assumed that patients take every dose as prescribed; costs were based on US wholesale acquisition cost (WAC) as of December 2017. The cost per additional responder for each product was calculated as the cost per induction year divided by the PASI 90 response rate. The PASI 90 response rate at 24 weeks were 80.2% for guselkumab and 30.0% for etanercept respectively. The annual costs for the induction year were $77,472 for guselkumab and $71,072 for etanercept. The cost per additional patient achieving PASI 90 response in the induction year was $96,598.50 for guselkumab versus $236,906.67 for etanercept. This cost per responder analysis demonstrates that guselkumab has a lower cost per PASI 90 responder than etanercept in the induction year and is therefore more cost-effective in patients with moderate to severe plaque psoriasis.