Cost–effectiveness and impact on quality of life of alefacept in the treatment of psoriasis

Abstract

Although alefacept was the first biologic agent approved to treat psoriasis, it is used less frequently than other biologic therapies. Alefacept decreases the Psoriasis Area and Severity Index (PASI) score and enhances the quality of life of patients with psoriasis. Unlike other biologics, alefacept can also induce remission of psoriasis. If reports in Pubmed and the package insert are considered to be surrogates for side effects, alefacept appears to be safer than other biologics. Alefacept can be effective against psoriatic arthritis, especially in combination with methotrexate. The response of psoriatics to alefacept, however, is inconsistent and often incomplete. Alefacept also has the highest cost of any biologic agent as measured by patients achieving PASI-75 and cost per patient achieving Dermatology Life Quality Index Minimal Important Difference. Traditional systemic therapies such as spriatane, ciclosporine, as well as phototherapy and TNF-α, possess firmer and superior pharmacoeconomic foundations, although some of these apparent cost–benefit disadvantages may take into account the ability of alefacept to induce remission after cessation of treatment.

Keywords::

• alefacept
• biologic
• pharmacoeconomics
• psoriasis

Acknowledgement

The authors would like to thank Steve Feldman for the inspiration and content of his work. The authors would also like to thank Paul Barth and the staff of the library of Roosevelt Hospital for their aid and patience.

Financial & competing interests disclosure

D Parish owns stock in Abbott, who produce Humira^®. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

Data from [44].