Cost-efficacy analysis of biological treatments in psoriasis: an 18-month assessment

Summary

This study compared the cost-efficacy of the following approved biological treatment strategies for plaque psoriasis over 18 months: (1) alefacept 15 mg intramuscularly weekly for two 12-week courses; (2) efalizumab 1 mg/kg subcutaneously (SC) weekly; and (3) etanercept 50 mg SC twice weekly for 12 weeks followed by a maintenance dose of 50 mg weekly. Direct utilisation-related costs included drug costs, office fees, injection fees and costs incurred due to adverse events and laboratory monitoring. Efficacy was based on response rates from large-scale clinical trials. At 18 months, total utilisation-related costs for alefacept, efalizumab and etanercept were $26,667, $33,365 and $32,962, respectively. Cost-efficacy, calculated using the corresponding response rates for the three therapies, was comparable ($66,669, $75,828 and $61,041, respectively). Thus, for patients with moderate to severe psoriasis who have responded to therapy, two 12-week courses of alefacept 7 months apart, or weekly maintenance treatment with efalizumab or etanercept, resulted in comparable total cost-efficacy.