Ilumya is among the most cost-effective first-line therapies for treating psoriasis, according to research presented by Justin Carrico, MD, of RTI Health Solutions, and colleagues at Academy of Managed Care Pharmacy Nexus.
Researchers used the perspective of a U.S. health plan to assess the cost impact of Ilumya (tildrakizumab, Sun Pharma) compared with Remicade (infliximab, Janssen), Otezla (apremilast, Celgene), Siliq (brodalumab, Ortho Dermatologics), Humira (adalimumab, AbbVie), Enbrel (etanercept, Amgen), Cosentyx (secukinumab, Novartis), Taltz (ixekizumab, Eli Lilly), Tremfya, (guselkumab, Janssen) and Stelara (ustekinumab, Janssen).
A 5-year budget-impact model was based on a health plan with 1 million members and based the amount of patients with psoriasis on the average rate of psoriasis in the U.S. of 3.2% (n = 5,242), with 20% of these receiving biologic treatment or apremilast (n = 1,048), according to a poster presented at the meeting.
In the 10-year cost-effectiveness model, patients who did not respond were determined by a 0% to 74% reduction in Psoriasis Area and Severity Index (PASI) score from baseline. One-quarter of nonresponders received various topical therapies, phototherapies and other oral systemic therapies until the end of the model time or death, according to the poster. The remaining 75% of patients received a second-line treatment of any treatments included in the first-line before receiving various topical therapies, phototherapies and other oral systemic therapies, if they did not respond to the second-line treatment. Topical therapies included over-the-counter topicals, corticosteroids and noncorticosteroids.
Currently, the researchers estimate that adalimumab, apremilast and secukinumab have the highest market share in biologics at 25%, 16% and 16%, respectively.
In annual drug costs based on wholesale acquisition costs, infliximab had the lowest drug cost in year 2 and after at less than $40,000 and ustekinumab had the highest at more than $70,000.
Apremilast had the lowest drug cost in year 1 vs. ixekizumab at more than $90,000.
Tildrakizumab cost in year 1 was more than $65,000, which decreased in year 2 and after.
Annual tildrakizumab costs from year 1 to year 10 were less than adalimumab, etanercept, secukinumab, ixekizumab, guselkumab and ustekinumab.
Additionally, incremental costs per extra month with a PASI-75 response was less in tildrakizumab than adalimumab, etanercept, secukinumab, ixekizumab, guselkumab and ustekinumab, according to researchers. – by Abigail Sutton
Carrico J, et al. Cost-effectiveness and budget impact of tildrakizumab for the treatment of moderate-to-severe plaque psoriasis using 2019 drug costs. Presented at: Academy of Managed Care Pharmacy Nexus; Oct. 29-Nov. 1, 2019; National Harbor, Maryland.
Disclosure: Healio Dermatology could not confirm relevant financial disclosures at the time of publication.