PSS16 - COST PER RESPONDER ANALYSIS OF CALCIPOTRIOL PLUS BETAMETHASONE DIPROPIONATE AEROSOL FOAM VERSUS NON-BIOLOGIC SYSTEMIC THERAPY IN THE TREATMENT OF MODERATE TO SEVERE PLAQUE PSORIASIS

Abstract

To compare the cost and efficacy of calcipotriol plus betamethasone dipropionate (Cal/BD) aerosol foam, used according to label, versus non-biologic systemic therapies in moderate to severe psoriasis. A series of matching-adjusted indirect comparisons (MAIC), matched on baseline characteristics, were used to compare 4-week efficacy (defined as ≥75% improvement on Psoriasis Area and Severity Index [PASI]) of Cal/BD foam versus 12-week efficacy of methotrexate (MTX), acitretin (AC), fumaric acid ester (FAE) and 16-week efficacy of apremilast (APR) for psoriasis patients (mean baseline PASI 7.3±4.6; BSA 7.3±6.1). Relevant comparators were defined by availability in the UK (APR, MTX, AC and FAE), Spain (APR, MTX and AC) and Portugal (MTX and AC). Cal/BD foam mean usage at week 4 was obtained from a pooled analysis of four studies and SmPC doses were considered for comparators. Drug and monitoring costs were calculated for each country based on local requirements and databases. Results were presented as cost per PASI75 responder. In the UK, Cal/BD foam was associated with a cost of less than £270 per responder compared to MTX (£1,287), APR (£9,179), AC (£1,617) and FAE (£2,097). In Spain, the cost per responder of Cal/BD foam was lower (€350) when compared to MTX oral and MTX IV (€882 and €1,310 per responder, respectively), APR (€15,728) and AC (€987). In Portugal, Cal/BD foam was associated with a cost per responder of less than €250 when compared to MTX oral and MTX IV (€553 and €1,366 per responder, respectively) and to AC (€918). Results were robust across scenarios exploring different assumptions for treatment duration and efficacy. The cost per PASI75 responder was lowest with Cal/BD foam, driven by higher efficacy and lower costs compared to oral systemics. Cal/BD foam is therefore likely to be a cost-effective treatment choice in UK, Spain and Portugal.