Secukinumab Vs. Adalimumab for the Treatment of Psoriatic Arthritis: A Cost Per Responder Analysis at 48 Weeks from an Argentinian Perspective

Abstract

To estimate and compare the long-term cost per responder (CPR) based on the American College of Rheumatology outcomes (ACR 20/50/70) following 48 weeks of psoriatic arthritis (PsA) treatment with secukinumab, the first and only fully human IL17-A antibody, relative to the anti-TNF adalimumab, in Argentina. The target population included biologic-naïve patients. The CPR for each treatment was calculated by dividing the drug acquisition cost for the course of treatment with its response rate. Drug costs were estimated based on the retail price and the number of doses required for 48 weeks. The long-term response rates were estimated using a matching-adjusted indirect comparison (MAIC) technique based on the data from FUTURE 2 and ADEPT clinical trials of secukinumab and adalimumab, respectively. Sensitivity analysis was conducted by varying baseline characteristics used in the MAIC analysis. The MAIC analysis showed that ACR (20/50/70) response rates were higher for secukinumab 150mg and 300mg compared to adalimumab at 48 weeks. ACR 20 response rates were 80%, 74% and 56%, ACR 50 response rates were 57%, 61% and 44%, whereas ACR 70 response rates were 32%, 43% and 30% for secukinumab 150mg, secukinumab 300mg, and adalimumab respectively. For PsA patients on secukinumab 150mg, secukinumab 300mg and adalimumab respectively, the costs per ACR 20 responder were ARS 394,615, ARS 854,584, and ARS 830,255; the costs per ACR 50 responder were ARS 549,906, ARS 1,023,150, and ARS 1,069,267; and the costs per ACR 70 responder were ARS 970,942, ARS 1,464,840, and ARS 1,568,259. The sensitivity analysis confirmed the robustness of the main analysis. The long-term CPR for ACR 50 and 70 response rates were consistently lower for secukinumab versus adalimumab. Furthermore, with better outcomes at lower costs, these findings suggest dominance of secukinumab over adalimumab. More PsA patients could be treated more effectively with secukinumab versus adalimumab, in Argentina.