PSS35 - SECUKINUMAB VERSUS USTEKINUMAB FOR THE TREATMENT OF PSORIASIS: A 52-WEEK COST PER RESPONDER ANALYSIS FROM THE PORTUGUESE PAYER PERSPECTIVE

Abstract

To estimate the cost per responder of psoriasis treatment with secukinumab 300 mg versus ustekinumab 45/90 mg from the Portuguese National Health System (NHS). The cost per responder for each treatment was estimated by dividing the drug acquisition cost of a 52-week course of treatment with its response rate based on the Psoriasis Area Severity Index outcomes (PASI75,PASI90 and PASI100). Drug acquisition costs were estimated using 2018 official prices from the perspective of the NHS (assuming ustekinumab 45mg cost); number of doses required for the course of treatment were defined according to the approved EU label. Response rates were obtained from the CLEAR clinical trial of secukinumab versus ustekinumab. PASI75, PASI90 and PASI100 response rates for secukinumab were 92%, 75% and 45% versus 78%, 61% and 37% for ustekinumab, respectively. The 52-week cost of secukinumab was €13,477 versus €14,894 for ustekinumab. For a given budget to treat 100 patients with ustekinumab, 111 patients could be treated with secukinumab instead. Cost per PASI75 responder for secukinumab and ustekinumab was €14,649 versus €19,095, cost per PASI90 responder was €17,969 versus €24,416, and cost per PASI100 responder was €29,949 versus €40,254, respectively. Response rates were higher for secukinumab compared to ustekinumab at 52 weeks for all PASI outcomes and cost estimates per responder were consistently lower for secukinumab. These findings indicate that it is more efficient to treat psoriatic patients with secukinumab than with ustekinumab in the Portuguese NHS.