Cost-effectiveness analysis of bimekizumab for the treatment of active psoriatic arthritis in Sweden
(2023) In Journal of Medical Economics 26(1). p.1190-1200- Abstract
Aims: To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective. Materials and methods: A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naïve or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was... (More)
Aims: To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective. Materials and methods: A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naïve or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was obtained from the BE OPTIMAL (bDMARD-naïve) and BE COMPLETE (TNFi-experienced) trials while a network meta-analysis (NMA) informed the efficacy of the comparators. Resource use and drug costs were obtained from published studies and databases of drug retail prices in Sweden. A willingness-to-pay threshold of €50,000 per quality-adjusted life year (QALY) was applied. Results: In bDMARD-naïve patients, bimekizumab achieved greater QALYs (14.08) than with all comparators except infliximab (14.22), dominated guselkumab every 4 and 8 weeks, ixekizumab, secukinumab 300 mg, ustekinumab 45 mg and 90 mg, and was cost-effective against risankizumab, tofacitinib, upadacitinib and TNFis, except adalimumab biosimilar. In TNFi-experienced patients, bimekizumab led to greater QALYs (13.56) than all comparators except certolizumab pegol (13.84), and dominated ixekizumab and secukinumab 300 mg while being cost-effective against all other IL-17A-, IL-23- and JAK inhibitors. Limitations: An NMA informed the comparative effectiveness estimates. Given gaps in evidence of disease management and indirect costs specific to HAQ-DI scores, and sequential clinical trial evidence in PsA, non-PsA cost data from similar joint conditions were used, and one line of active treatment followed by best supportive care was assumed. Conclusions: Bimekizumab was cost-effective against most available treatments for PsA in Sweden, irrespective of prior TNFi exposure.
(Less)
- author
- Sigurdardottir, Valgerdur ; Engstrom, Anna ; Berling, Patric ; Olofsson, Tor LU ; Oldsberg, Linnea ; Sadler, Susannah ; Parra-Padilla, Devian ; Melis, Lode and Willems, Damon
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- bimekizumab, Cost-effectiveness analysis, economic evaluation, incremental cost-effectiveness ratio (ICER), psoriatic arthritis, sweden
- in
- Journal of Medical Economics
- volume
- 26
- issue
- 1
- pages
- 11 pages
- publisher
- Informa Healthcare
- external identifiers
-
- pmid:37712618
- scopus:85173513684
- ISSN
- 1369-6998
- DOI
- 10.1080/13696998.2023.2259609
- language
- English
- LU publication?
- yes
- id
- d4e733b6-c611-4012-8cfa-e062f707fab2
- date added to LUP
- 2023-12-19 14:45:51
- date last changed
- 2024-04-18 00:58:39
@article{d4e733b6-c611-4012-8cfa-e062f707fab2,
abstract = {{<p>Aims: To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective. Materials and methods: A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naïve or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was obtained from the BE OPTIMAL (bDMARD-naïve) and BE COMPLETE (TNFi-experienced) trials while a network meta-analysis (NMA) informed the efficacy of the comparators. Resource use and drug costs were obtained from published studies and databases of drug retail prices in Sweden. A willingness-to-pay threshold of €50,000 per quality-adjusted life year (QALY) was applied. Results: In bDMARD-naïve patients, bimekizumab achieved greater QALYs (14.08) than with all comparators except infliximab (14.22), dominated guselkumab every 4 and 8 weeks, ixekizumab, secukinumab 300 mg, ustekinumab 45 mg and 90 mg, and was cost-effective against risankizumab, tofacitinib, upadacitinib and TNFis, except adalimumab biosimilar. In TNFi-experienced patients, bimekizumab led to greater QALYs (13.56) than all comparators except certolizumab pegol (13.84), and dominated ixekizumab and secukinumab 300 mg while being cost-effective against all other IL-17A-, IL-23- and JAK inhibitors. Limitations: An NMA informed the comparative effectiveness estimates. Given gaps in evidence of disease management and indirect costs specific to HAQ-DI scores, and sequential clinical trial evidence in PsA, non-PsA cost data from similar joint conditions were used, and one line of active treatment followed by best supportive care was assumed. Conclusions: Bimekizumab was cost-effective against most available treatments for PsA in Sweden, irrespective of prior TNFi exposure.</p>}},
author = {{Sigurdardottir, Valgerdur and Engstrom, Anna and Berling, Patric and Olofsson, Tor and Oldsberg, Linnea and Sadler, Susannah and Parra-Padilla, Devian and Melis, Lode and Willems, Damon}},
issn = {{1369-6998}},
keywords = {{bimekizumab; Cost-effectiveness analysis; economic evaluation; incremental cost-effectiveness ratio (ICER); psoriatic arthritis; sweden}},
language = {{eng}},
number = {{1}},
pages = {{1190--1200}},
publisher = {{Informa Healthcare}},
series = {{Journal of Medical Economics}},
title = {{Cost-effectiveness analysis of bimekizumab for the treatment of active psoriatic arthritis in Sweden}},
url = {{http://dx.doi.org/10.1080/13696998.2023.2259609}},
doi = {{10.1080/13696998.2023.2259609}},
volume = {{26}},
year = {{2023}},
}