Cost-efficacy of biologic therapies for moderate to severe psoriasis from the perspective of the Taiwanese healthcare system

Authors

  • Shu-Hui Wang MD, MS,

    1. Department of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan
    2. Department of Healthcare Administration, Oriental Institute of Technology, New Taipei, Taiwan
    3. Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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  • Ching-Chi Chi MD, MMS, DPhil (Oxf),

    Corresponding author
    1. Department of Dermatology, Chang Gung Memorial Hospital Chiayi, Chiayi, Taiwan
    2. College of Medicine, Chang Gung University, Taoyuan, Taiwan
    • Correspondence

      Ching-Chi Chi, md, mms, dphil

      Department of Dermatology

      Chang Gung Memorial Hospital, Chiayi

      6, Section West, Chia-Pu Road

      Puzih, Chiayi 61363, Taiwan

      E-mails: chingchi@cgmh.org.tw; chingchichi@gmail.com

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  • Sindy Hu MD, MS

    1. Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan, Taiwan
    2. College of Medicine, Chang Gung University, Taoyuan, Taiwan
    3. Department of Dermatology, Chang Gung Memorial Hospital Taoyuan, Taoyuan, Taiwan
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  • Conflicts of interest: None.

Abstract

Background

Biologic therapies are more effective than conventional therapies in the treatment of psoriasis, but they are also more costly.

Objectives

The aim of this study was to compare the cost-efficacy of etanercept, adalimumab, and ustekinumab therapies in the treatment of moderate to severe psoriasis in a Taiwanese setting.

Methods

We conducted a meta-analysis of randomized, placebo-controlled trials to calculate the incremental efficacy of etanercept, adalimumab, and ustekinumab, respectively, in affecting a reduction of ≥75% in score on the Psoriasis Area and Severity Index (PASI 75). The base, best case, and worst case incremental cost-effectiveness ratios (ICERs) for one subject to achieve PASI 75 were calculated for the purposes of economic analysis.

Results

One-year ICERs per PASI 75 responder were US$ 39,709 (best scenario US$ 36,400; worst scenario US$ 43,680), US$ 23,711 (best scenario US$ 22,633; worst scenario US$ 25,319), and US$ 26,329 (best scenario US$ 24,780; worst scenario US$ 27,623) for etanercept, adalimumab, and ustekinumab, respectively. Two year ICERs per PASI 75 responder were US$ 71,973 (best scenario US$ 65,975; worst scenario US$ 79,170), US$ 62,665 (best scenario US$ 59,817; worst scenario US$ 66,914), and US$ 52,657 (best scenario US$ 49,560; worst scenario US$ 55,427) for etanercept, adalimumab, and ustekinumab, respectively.

Conclusions

In a Taiwanese setting, adalimumab and ustekinumab had lower 1-year costs per PASI 75 responder than etanercept, and ustekinumab had the lowest 2-year cost per PASI 75 responder.

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