Number needed to treat and costs per responder among biologic treatments for moderate-to-severe plaque psoriasis in Japan

Abstract

Background: Biologics have been shown to improve the outcomes of patients with psoriasis but their cost is an issue.

Objective: Determine the number needed to treat (NNT) to achieve a 75%/90% reduction in the Psoriasis Area and Severity Index (PASI-75/90) and evaluate the incremental cost per PASI-75/90 responder (CPR) relative to placebo in Japan.

Methods: A network meta-analysis was conducted to estimate the relative probabilities of achieving PASI-75/90 and NNTs. Drug costs were assessed based on Pharmaceutical and Medical Device Agency-approved dosing. The CPR was estimated for a short-term induction period and first year of treatment.

Results: Compared with placebo, the PASI-75 NNT was 1.27 for adalimumab 80 mg, 1.29 for secukinumab 150 mg, 1.36 for secukinumab 300 mg, 1.57 for adalimumab 40 mg, 1.68 for ustekinumab 90 mg, 1.97 for ustekinumab 45 mg and 2.00 for infliximab 5 mg/kg. The short-term PASI-75 CPR relative to placebo was $5,062 for secukinumab 150 mg, $8209 for adalimumab 40 mg, $10,654 for secukinumab 300 mg, $11,754 for adalimumab 80 mg, $15,407 for ustekinumab 45 mg, $19,147 for infliximab 5 mg/kg and $26,257 for ustekinumab 90 mg. A similar ranking was observed for one-year PASI-75 CPRs and PASI-90 NNTs and CPRs.

Conclusion: Adalimumab 40 mg/80 mg and secukinumab 150 mg/300 mg were the most efficacious and cost-efficient for patients with psoriasis in Japan.

Keywords:

• Moderate-to-severe psoriasis
• biological therapies
• psoriasis area and severity index
• network meta-analysis
• number needed to treat
• cost per responder

Acknowledgements

Cheryl Q. Xiang, Ariadne Souroutzidis and Jing Zhao, employees from Analysis Group, Inc. contributed to design of the study and data analysis. Medical writing assistance was provided by Cinzia Metallo, PhD, an employee of Analysis Group, Inc.

Disclosure statement

Shinichi Imafuku has received lecture honoraria from Eisai, AbbVie, Tanabe-Mitsubishi, Janssen, Novartis, Maruho, Kyowa-Kirin, Leo pharma, Elli Lilly, and Torii, and research funds from Eisai, AbbVie, Tanabe-Mitsubishi, Novartis, Maruho, Kyowa-Kirin, Leo pharma, and Torii.

Ataru Nakano and Hidetoshi Dakeshita are employees of AbbVie GK.

Junlong Li, Keith Betts, and Annie Guerin are employees of Analysis Group Inc., which has received consultancy fees from AbbVie GK.

Additional information

Funding

This study was provided by AbbVie GK, which participated in the interpretation of the data, and the review and approval of the manuscript.