Economic Evaluation of Selected Interleukin Inhibitors Versus Methotrexate for Moderate-to-Severe Plaque Psoriasis From the Philippine Payer Perspective.

Autor: Kimwell MJM; School of Economics, University of the Philippines, Diliman, Quezon City, Philippines. Electronic address: mmkimwell@up.edu.ph., de Guzman DC; Technical and Policy Committee, Philippine Society of Public Health Physicians, Parañaque, Philippines., Onda AJM; University of the Philippines Manila, Manila, Philippines., Dofitas BL; Department of Dermatology, University of the Philippines Manila - Philippine General Hospital, Manila, Philippines., Frez MLF; Department of Dermatology, University of the Philippines Manila - Philippine General Hospital, Manila, Philippines., Mendoza CG; Immunodermatology Unit, Research Institute for Tropical Medicine, Muntinlupa, Philippines., Rivera FD 4th; Department of Medical Dermatology, Rizal Medical Center, Pasig, Philippines., Almirol BJQ; Value and Access, Novartis Healthcare Philippines, Inc, Makati City, Philippines., Malaluan MJQ; Clinical Development and Medical Affairs, Novartis Healthcare Philippines, Inc, Makati City, Philippines., Guce K; Value and Access, Novartis Healthcare Philippines, Inc, Makati City, Philippines.
Jazyk: angličtina
Zdroj: Value in health regional issues [Value Health Reg Issues] 2023 Mar; Vol. 34, pp. 100-107. Date of Electronic Publication: 2023 Jan 11.
DOI: 10.1016/j.vhri.2022.12.001
Abstrakt: Objectives: We conducted an economic evaluation of interleukin inhibitors (ILIs) guselkumab, ixekizumab (IXE), secukinumab (SEC), and ustekinumab to a methotrexate (MTX) comparator for biologic-naive adult Filipino patients with moderate-to-severe chronic plaque psoriasis.
Methods: A 1-year decision tree and 5-year Markov model were used to estimate incremental cost-effectiveness ratios (ICERs) in Philippine pesos (PHP) per Psoriasis Area Severity Index improvement of at least 75%. For health technology assessment purposes, we also estimated the budget impact of subsidies for SEC to a Government of the Philippines (GoP) payer. Deterministic and probabilistic sensitivity analyses were performed. Data sources included global literature and local intervention prices.
Results: All ILIs were more effective but also more expensive than MTX. In the base case, only IXE and SEC were cost-effective treatments at a gross domestic product-benchmarked threshold, yielding ICERs of PHP468 098.01 and PHP483 525.32 per PASI responder, respectively. GUS and UST were less likely to be cost-effective throughout a range of simulated thresholds. ICERs were most responsive to discontinuation rates and drug prices. Full subsidy of SEC for 5 years would cost the GoP PHP1.83 billion more than a similar subsidy for MTX.
Conclusions: ILIs were clearly more effective than MTX, but only IXE and SEC were potentially cost-effective for a GoP payer. Any case in which SEC is fully subsidized is more expensive to the GoP than the base case. This study was limited by a lack of country-specific effectiveness data, underestimation of comparator costs, exclusion of noncutaneous and quality-of-life effects, and indirect costs.
(Copyright © 2022 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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