Section : Notes de congrès/conférences

Psoriasis cost-effective treatments

Cost per responder of apremilast versus etanercept, adalimumab, and ustekinumab in Patients with moderate to severe psoriasis (Poster)

Feldman SR et al

AAD 2015 Annual Meeting, San Francisco CA – United States

  • With the injected biologics treatment for psoriasis and the newer oral “small molecules” for the treatment of psoriasis the authors found it useful to compare the pricing of these treatments before the evaluation of treatment effectiveness could be done

Methods

  • study done in the United States
  • patients were assessed whether they were responders
  • “responders” is defined as an at least 75 % improvement of their psoriasis (PASI75)
  • The cost for 100 responders was compared between:
    • adalimumab (humira)
    • etanercept (enbrel)
    • apremilast (otezla)
    • ustekinumab 45mg (stelara)
    • ustekinumab 90mg (stelara)

Results (in ascending order)

  • apremilast (otezla)                          $1893761        response rate 31.9%
  • adalimumab (humira)                     $2048801        response rate 65.9%
  • ustekinumab 45mg (stelara)         $2233574         response rate 68.6 %
  • etanercept (enbrel)                         $3350840        response rate 52.6%
  • ustekinumab 90mg (stelara)         $4141157          response rate 74%

Conclusion

  • Apremilast is the least expensive of the “modern” drugs for the treatment of psoriasis.
  • The response rate for apremilast is lower than the biologics (31.9%) but it also has the advantage of being “swallowed” as a tablet and not injected.
  • Compliance is also relevant when evaluating if a drug is effective or not as the medication needs to be taken indefinately

Comments

  • The frontier between moderator and severe psoriasis is not defined (often though clinecal evaluation can be subjective in not using PGA or PASI)
  • The study hasn’t compared biologics with conventional treatments such as phototherapy and methotrexate.
  • Also not all the biologics have been included in the study.

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland