Comparative cost-effectiveness of tildrakizumab and other commonly used treatments for moderate-to-severe psoriasis.
OBJECTIVES
To compare the cost-effectiveness of tildrakizumab with other commonly used biologics and apremilast as the first-line treatment for moderate-to-severe plaque psoriasis from a US health plan's perspective.


METHODS
A 10-year cost-effectiveness model was developed to compare the incremental cost per extra month with a Psoriasis Area and Severity Index (PASI) 75 response. Patients were assumed to receive one of the treatments evaluated as their first-line treatment at the outset of the analysis. Nonresponders (PASI <75) discontinued their current treatment; 25% went on to receive a mix of topical therapies, phototherapies, and other systemic therapies, while 75% received a second-line therapy before receiving a mix of topical therapies, phototherapies, and other systemic therapies. Direct medical costs were calculated based on drug acquisition, administration, and monitoring costs.


RESULTS
The incremental cost per extra month a patient had a PASI 75 response was lowest for brodalumab ($3,685), infliximab ($4,102), apremilast ($4,770), and tildrakizumab ($5,150), followed by risankizumab ($5,319), secukinumab ($5,675), guselkumab ($5,784), ixekizumab ($5,900), adalimumab ($5,943), ustekinumab ($6,131), etanercept ($6,618), and certolizumab pegol ($13,476).


CONCLUSION
Tildrakizumab was among the most cost-effective first-line treatments for moderate-to-severe psoriasis and was more cost-effective than risankizumab, secukinumab, guselkumab, ixekizumab, adalimumab, ustekinumab, etanercept, and certolizumab pegol.
['Wu|Jashin J|JJ|', 'Jia|Xiaoying|X|', 'Zhao|Yang|Y|', 'Carrico|Justin|J|', 'Brodtkorb|Thor-Henrik|TH|', 'Mendelsohn|Alan|A|', 'Lowry|Simon|S|', 'Feldman|Steven R|SR|0000-0002-0090-6289', 'Armstrong|April|A|']
D061067:Antibodies, Monoclonal, Humanized D003362:Cost-Benefit Analysis D000068800:Etanercept D006801:Humans D011565:Psoriasis D012720:Severity of Illness Index D016896:Treatment Outcome D000069549:Ustekinumab
Psoriasis apremilast biologic therapy cost effectiveness