Treatment with secukinumab resulted in better response rates and a lower cost per responder compared with adalimumab among patients with psoriatic arthritis in the United States, according to findings presented at the American College of Rheumatology Annual Meeting.
Jeffrey D. Greenberg, MD, MPH, of New York University School of Medicine, and colleagues examined long-term cost per responder after 48 weeks among patients treated with secukinumab (Cosentyx, Novartis), an interleukin-17A inhibitor, or adalimumab (Humira, AbbVie), an anti-tumor necrosis factor (anti-TNF) agent. Cost per responder for each treatment was estimated by dividing the cost of acquiring the drug for the duration of treatment by the response rate for the agent. The official U.S. acquisition cost of the drug and the number of doses needed for 48 weeks were used to estimate the cost of each agent.
Researchers used a matching-adjusted indirect comparison based on data from the FUTURE 2 trial of secukinumab and the ADEPT trial of adalimumab to assess long-term response rates. Matching-adjusted indirect comparisons paired age, weight, race, gender, psoriasis area and severity index (PASI) and health assessment questionnaire-disability index (HAQ-DI) scores, duration of psoriatic arthritis (in years), number of swollen joints, C-reactive protein (CRP) and the number of patients taking methotrexate with a body surface area for psoriasis of greater than or equal to 3%, the presence of dactylitis and enthesitis, and no treatment with TNF inhibitors at baseline. Researchers also conducted a sensitivity analysis that varied the selection of baseline characteristics examined in the matching-adjusted indirect comparison, including all variables except duration of psoriatic arthritis (in years), swollen joint count and CRP.
After pairing the baseline characteristics, the sample sizes for secukinumab 150 mg and 300 mg were 15 and 25, respectively, and 151 for adalimumab. Matching-adjusted indirect comparisons analysis demonstrated ACR20, ACR50 and ACR70 responses were higher for both the 150-mg and 300-mg doses of secukinumab compared with adalimumab at 48 weeks. Response rates for secukinumab 150 mg, secukinumab 300 mg and adalimumab were 79%, 82% and 56%, respectively, for ACR20; 68%, 73% and 44%, respectively, for ACR50; and 39%, 50% and 30% for ACR70.
Cost per responder for secukinumab 150 mg, secukinumab 300 mg and adalimumab were $72,906, $70,993 and $80,412, respectively, for ACR20; $85,480, $79,760 and $103,561, respectively, for ACR50; and $150,276, $115,934 and $151,890, respectively, for ACR70.
Sensitivity analyses demonstrated comparable findings for both ACR response rates and cost per responder.
“These findings indicate that secukinumab represents a cost-efficient treatment choice for [psoriatic arthritis] PsA patients in the U.S.,” the researchers wrote. – by Julia Ernst, MS
Greenberg JD, et al. Abstract 1245. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.
Disclosures: Greenberg reports associations with Novartis. Please see the full study for a list of all other researchers’ relevant financial disclosures.