To estimate the cost per responder of psoriatic arthritis (PsA) treatment with secukinumab versus etanercept biosimilar from the Portuguese National Health System (NHS). The cost per responder for each treatment was estimated by dividing the drug acquisition cost of a 24-week course of treatment with its response rate based on the American College of Rheumatology outcomes (ACR20/50/70). Drug acquisition costs were estimated using 2018 official prices from the perspective of the NHS; number of doses required for the course of treatment were defined according to the approved EU label. Response rates were estimated using a matching-adjusted indirect comparison (MAIC) based on the data from FUTURE 2 and ETN clinical trials of secukinumab and etanercept, respectively. MAIC analysis matched the age, weight, race and gender, and other relevant baseline characteristics, such as PASI score, HAQ-DI score, methotrexate use, psoriasis on ≥3% of BSA, dactylitis, enthesitis, and previous use of anti-TNF. The predicted ACR20, 50 and 70 response rates were 73.3%, 52.4% and 30.1% for secukinumab 150mg, 74.4%, 45.7% and 25.3% for secukinumab 300mg and 54.4%, 42.2% and 10.0% for etanercept biosimilar 50mg, respectively. The 24-week cost of secukinumab 150mg/300mg was €3,790/€7,581 versus €3,312 for etanercept biosimilar. Estimates of the cost per ACR20 responder were €5,171, €10,189 and €6,088, cost per ACR50 responder €7,234, €16,588 and €7,848, and cost per ACR70 responder €12,593, €29,964 and €33,120 for secukinumab 150mg, secukinumab 300mg and etanercept biosimilar, respectively. Response rates were higher for secukinumab compared to etanercept biosimilar at 24 weeks and cost per responder were consistently lower for secukinumab 150mg for all ACR outcomes and for secukinumab 300mg when considering the most difficult-to-reach outcome.