PSS6 - The Budget Impact of Brodalumab for the Treatment of Moderate-to-Severe Plaque Psoriasis on U.S. Commercial Health Plans

Abstract

Brodalumab was approved by the US Food and Drug Administration in February of 2017 for the treatment of moderate-severe plaque psoriasis. We evaluated how the introduction of brodalumab for this indication impacts the pharmacy budget of US commercial health plans. An Excel-based economic model with a US health plan perspective was developed. The model incorporated moderate-to-severe psoriasis prevalence, market shares of common biologics, including adalimumab, ustekinumab, secukinumab, ixekizumab and etanercept, used for the treatment of moderate-severe psoriasis, 2017-year Wholesale Acquisition Costs, drug dispensing fee, patient co-pay, and drug contracting discount. Annual costs for treatment of moderate-to-severe plaque psoriasis patients with the biologics were estimated. Scenarios with different proportions of patients treated with brodalumab were compared to a scenario when no brodalumab was used. Prior to the introduction of brodalumab to the US market, the proportions of moderate-to-severe psoriasis patients treated with other biologics were estimated at 50.8%, 13.5%, 14.1%, 4.4% and 17.2% for adalimumab, ustekinumab, secukinumab, ixekizumab, and etanercept, respectively. In the absence of brodalumab, the total annual pharmacy budget for the biologics used among an expected 7,038 eligible moderate-to-severe psoriasis patients was estimated at $405,383,695. With a 20% drug price discount applied to all biologics, the annual health plan costs for brodalumab, adalimumab, ustekinumab, secukinumab, ixekizumab, and etanercept were estimated at $37,224, $49,166, $55,084, $56,061, $64,396, and $57,170, respectively. When the potential proportions of patients with brodalumab usage were assumed to be 3%, 8%, 16%, and 30%, the total annual pharmacy cost for the treatment of moderate-to-severe plaque psoriasis was predicted to decrease by $3,428,760, $9,143,361, $18,286,722, and $34,287,605, respectively, due to the lower drug cost of brodalumab. The findings of this cost-analysis show that increasing access to brodalumab for patients with moderate-to-severe plaque psoriasis will likely considerably reduce pharmacy expenditures for US health plans.