If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Systemic Treatment With Biologics, Especially Infliximab, Is the Most Cost-Effective Therapy for Patients With Mild to Severe Psoriasis: Presented at EADV By Jenny Powers BERLIN -- October 12, 2009 -- According to the results of an analysis done for the Swiss Healthcare system that both determined direct treatment costs and compared the response rate of systemic treatment of 5 biologics, infliximab had both the highest response rate and was the most cost-effective treatment. The study, presented here at the 18th Congress of the European Academy of Dermatology and Venereology (EADV), compared the incremental cost-effectiveness ratios and overall response in patients with mild to severe psoriasis who were treated with infliximab, etanercept, adalimumab, efalizumab, or alefacept. Roger-Axel Greiner, a Health Economics Consultant from Lörrach, Germany, conducted the analysis with Lasse R. Braathen, MD, Dermatology University of the Inselspital of Berne, Berne, Switzerland, and presented the results here on October 9. Together they sought to examine the current study results from randomised, controlled trials for biologics that are approved in Switzerland and used throughout Europe to determine whether the costs, risks, and efficacy of one treatment outweighs those of others. The following treatment regimens were compared: (1) intravenous (IV) infliximab 5 mg/kg at weeks 0, 2, 6, and every subsequent 8 weeks; (2) subcutaneous (SC) etanercept 50 mg twice weekly (tw) for 12 weeks, then 25 mg tw; (3) adalimumab 80 mg SC week 0, then 40 mg every other week; (4) efalizumab 1 mg/kg/week SC; and (5) intramuscular (IM) alefacept 15 mg/week for 12 weeks. The cost-effectiveness analysis at 12 weeks revealed that differences in cost-effectiveness between biologics strongly increase with the strictness of Psoriasis Area Severity Index (PASI) measure. Infliximab treatment had the highest response rates, 83.2%, 77.8%, and 55.8% of patients achieving PASI 50, 75, and 90, respectively at 12 weeks, with similar rates seen at 24 weeks. The second strongest response rates were seen with the etanercept regimen with 68.0%, 46.4%, and 20.1% of patients achieving PASI 50, 75, and 90, respectively at 12 weeks, also with similar rates seen at 24 weeks. Adalimumab and efalizumab had lower response rate and alefacept the lowest with 25% and 16% of patients achieving PASI 50 and 75 at 12 weeks and no patients achieving PASI 90 at both time points. At 12 weeks, the most cost-effective treatment was infliximab followed by adalimumab, efalizumab, etanercept, and alefacept. Interestingly, cost-effectiveness was the lowest for adalimumab for achieving PASI 50 and 75 but triple that of infliximab at PASI 90. This trend was also seen with etanercept and efalizumab, with the latter displaying costs of over 6 times that of infliximab at PASI 90. The authors concluded that selecting a biological therapy with a high response rate was more cost-effective than with a low response rate. Furthermore, in this analysis, infliximab had the strongest response rate in terms of PASI 50, 75, and 90 at 12 and 24 weeks. Funding for this study was provided by Essex Chemicals, Lucerne, CH. [Presentation title: Cost-Effectiveness of Biologics for Moderate-to-Severe Psoriasis From the Perspective of the Swiss Healthcare System. Abstract P1217]
|
