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• W2169364545 abstract "Objective: To compare the cost-efficacy of biologics in the treatment of psoriasis using the Psoriasis Area and Severity Index (PASI) response criteria as the efficacy endpoint.Methods: A cost-efficacy analysis was conducted comparing biologics used in the treatment of psoriasis. This aspect focuses on alefacept 7.5mg IV weekly (qw) or 15mg IM qw and etanercept 25mg subcutaneous (SQ) twice weekly (biw) or 50mg SQ biw. The perspective of this analysis was a US managed care organization. A three-month time horizon was chosen based on the availability of efficacy data (PASI-50 and PASI-75) from comparable clinical trials. Medication costs were based on US average wholesale price (AWP). Other direct costs, including those for physician office visits, laboratory monitoring, and drug administration, were based on Medicare reimbursement rates and the MEDSTAT DRG Guide. Adverse events were assumed to be equal for all treatment arms based on reporting in package inserts; they were grouped into mild, moderate or severe for calculation of their treatment costs. It was assumed that 5% of patients dropped out of each treatment arm at 6 weeks due to severe adverse events. Sensitivity analyses were conducted on drug costs, adverse event rates and efficacy measures.Results: The total cost for each regimen over the three-month time course, adjusted for the dropout rate, was: etanercept 25mg = $4130; etanercept 50mg = $7945; alefacept IV = $9504; alefacept IM = $12850. Efficacy measures for each regimen were: etanercept 25mg, PASI-50 = 0.44 and PASI-75 = 0.30; etanercept 50mg, PASI-50 = 0.0.60 and PASI-75 = 0.45; alefacept IV, PASI-50 = 0.28 and PASI-75 = 0.10; alefacept IM, PASI-50 = 0.24 and PASI-75 = 0.16. The cost per PASI-50 responder for alefacept 7.5mg IV qw and 15mg IM qw were $33939 and $53542, respectively. The cost per PASI-50 responder for etanercept 25mg SQ biw and 50mg SQ biw were $9386 and $13240 respectively. The cost per PASI-75 responder for alefacept 7.5mg IV qw and 15mg IM qw were $95030 and $80313, rsepectively. The cost per PASI-75 responder for etanercept 25mg SQ biw and 50mg SQ biw were $13767 and $17653 respectively. The results were sensitive to both drug cost and efficacy rate. Etanercept dominated alefacept in each analysis (that is, had lower cost and higher efficacy). Results from analyses with other biologics will also be presented.Conclusions: Results suggest that etanercept is associated with a lower cost per PASI-50 and PASI-75 responder and therefore is more cost-efficacious compared to alefacept for the treatment of psoriasis. Objective: To compare the cost-efficacy of biologics in the treatment of psoriasis using the Psoriasis Area and Severity Index (PASI) response criteria as the efficacy endpoint. Methods: A cost-efficacy analysis was conducted comparing biologics used in the treatment of psoriasis. This aspect focuses on alefacept 7.5mg IV weekly (qw) or 15mg IM qw and etanercept 25mg subcutaneous (SQ) twice weekly (biw) or 50mg SQ biw. The perspective of this analysis was a US managed care organization. A three-month time horizon was chosen based on the availability of efficacy data (PASI-50 and PASI-75) from comparable clinical trials. Medication costs were based on US average wholesale price (AWP). Other direct costs, including those for physician office visits, laboratory monitoring, and drug administration, were based on Medicare reimbursement rates and the MEDSTAT DRG Guide. Adverse events were assumed to be equal for all treatment arms based on reporting in package inserts; they were grouped into mild, moderate or severe for calculation of their treatment costs. It was assumed that 5% of patients dropped out of each treatment arm at 6 weeks due to severe adverse events. Sensitivity analyses were conducted on drug costs, adverse event rates and efficacy measures. Results: The total cost for each regimen over the three-month time course, adjusted for the dropout rate, was: etanercept 25mg = $4130; etanercept 50mg = $7945; alefacept IV = $9504; alefacept IM = $12850. Efficacy measures for each regimen were: etanercept 25mg, PASI-50 = 0.44 and PASI-75 = 0.30; etanercept 50mg, PASI-50 = 0.0.60 and PASI-75 = 0.45; alefacept IV, PASI-50 = 0.28 and PASI-75 = 0.10; alefacept IM, PASI-50 = 0.24 and PASI-75 = 0.16. The cost per PASI-50 responder for alefacept 7.5mg IV qw and 15mg IM qw were $33939 and $53542, respectively. The cost per PASI-50 responder for etanercept 25mg SQ biw and 50mg SQ biw were $9386 and $13240 respectively. The cost per PASI-75 responder for alefacept 7.5mg IV qw and 15mg IM qw were $95030 and $80313, rsepectively. The cost per PASI-75 responder for etanercept 25mg SQ biw and 50mg SQ biw were $13767 and $17653 respectively. The results were sensitive to both drug cost and efficacy rate. Etanercept dominated alefacept in each analysis (that is, had lower cost and higher efficacy). Results from analyses with other biologics will also be presented. Conclusions: Results suggest that etanercept is associated with a lower cost per PASI-50 and PASI-75 responder and therefore is more cost-efficacious compared to alefacept for the treatment of psoriasis." @default.
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• W2169364545 date "2004-03-01" @default.
• W2169364545 modified "2023-09-27" @default.
• W2169364545 title "Cost efficacy comparison of biologics in the treatment of psoriasis" @default.
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