Secukinumab as first-line biologic treatment is the most efficient treatment for moderate-to-severe plaque psoriasis in the short-to-medium term, according to a recent study. Researchers built a decision tree with a 2-year time horizon. Efficacy data for biologics was drawn from published meta-analyses: PASI75 for the induction phase and PASI90 for the rest of follow-up. Patients with PASI <75 at week 10-16 were switched to another biologic agent. Efficacy at week 24 was considered the highest possible efficacy for each drug and assumed to remain constant throughout the 2-year period. The Number Needed to Treat (NNT), annual cost per patient, annual cost per patient with PASI90 (cost per responder), and cost of primary failure (PASI <75 at first efficacy evaluation) were calculated. They found:
- Secukinumab monotherapy was associated with the lowest cost per responder, as compared with other biologics in the study.
- Treatment sequences starting with secukinumab were the most efficient, having the lowest NNT and cost per responder.
- Although annual cost per treatment is similar for all drugs, there are huge differences in the cost per responder.
Puig L, Notario J, Jiménez-Morales A, et al. Secukinumab is the most efficient treatment for achieving clear skin in psoriatic patients: A cost-consequence study from the Spanish National Health Service. [Published online ahead of print August 8, 2017]. J Dermatolog Treat. doi:10.1080/09546634.2017.1364687.