Cost per responder analysis of ustekinumab and etanercept for moderate to severe plaque psoriasis

Abstract

Objective: To compare the cost per responder of ustekinumab with etanercept based on data from the active comparator ACCEPT trial. Methods: In ACCEPT, patients received ustekinumab 45 mg (n = 209) or 90 mg (n = 347) at weeks 0 and 4 or etanercept 50 mg (n = 347) twice weekly for 12 weeks. The proportions of patients achieving ≥75% improvement in the Psoriasis Area and Severity Index [PASI 75] were determined at week 12. The cost per PASI 75 responder was determined for week 16, a time coinciding with treatment coverage of both drugs and accounting for the different dosing intervals. Costs for 16 weeks of therapy were based on the Wholesale Acquisition Cost (WAC) in the United States. The analysis used weight-based efficacy results for ustekinumab (45 mg for patients ≤ 100 kg; 90 mg for patients > 100 kg) and overall efficacy for etanercept, consistent with the approved dosages. Results: A total of 28% of patients weighed > 100 kg. The PASI 75 response rates at week 12 were 72.2% for the ustekinumab 45 mg group in patients ≤ 100 kg, 65.0% for the ustekinumab 90 mg group in patients > 100 kg, and 56.8% for the etanercept group. At week 16, the cost per responder was $17 842 for ustekinumab and $20 077 for etanercept. Conclusion: The cost per responder was lower for ustekinumab than for etanercept through 16 weeks in psoriasis patients.

Key words::

• cost
• etanercept
• psoriasis
• ustekinumab

Acknowledgements

The authors thank Alexa B. Kimball, MD, for her input in the cost per responder analysis. The authors acknowledge the support of Rebecca E. Clemente, PhD, and Mary Whitman, PhD, of Centocor Ortho Biotech Services, LLC, in editing this manuscript.

Funding: The ACCEPT trial was sponsored by Centocor Research & Development, Inc., and the analyses contained herein were sponsored by Johnson & Johnson Pharmaceutical Services, LLC.

Conflict of interest: Authors SM, PS, and BS are employees of Johnson & Johnson subsidiaries and own stock in Johnson & Johnson.

SRF has received grant support from 3M, Abbott Labs, Amgen, Astellas, Aventis Pharmaceuticals, Biogenidec, Bristol-Myers Squibb Dermatology, Centocor, Connetics Corporation, Coria, Galderma, National Psoriasis Foundation, Ortho Pharmaceuticals, Pharmaderm, Roche Dermatology, and Warner Chilcott; has been a speaker and consultant for Abbott Labs, Amgen, Biogenidec, Bristol-Myers Squibb Dermatology, Centocor, Connetics Corporation, Galderma, Genentech, and Warner Chilcott; has been a consultant for Photomedex; has been a speaker for 3M and Novartis; has given research support to Genentech, Novartis, and Photomedex; has received stock options from Photomedex; and has received research grants from the American Society for Dermatologic Surgery and the Dermatology Foundation.

MA is on advisory boards for Abbott, Centocor, Janssen-Cilag, Schering-Plough, and Wyeth; is an investigator for Abbott, Biogen, Centocor, Janssen-Cilag, Schering-Plough, and Wyeth; and is on speakers' bureaus for Abbott, Biogen, Janssen-Cilag, Schering-Plough, and Wyeth.