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Abstract
Aim
This study assesses the cost-effectiveness of secukinumab vs currently licensed biologics for the treatment of ankylosing spondylitis (AS) from the Finnish health care system perspective.
Methods
A semi-Markov model compared secukinumab with adalimumab, adalimumab biosimilar, certolizumab pegol, etanercept, etanercept biosimilar, golimumab, and infliximab in a biologic-naïve population over a lifetime horizon. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess the treatment response. Efficacy inputs were obtained from the network meta-analysis, and other model inputs were obtained from the published literature and Finnish sources. Main study outcomes included quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratio in terms of cost per QALY gained. Robustness of results was confirmed by sensitivity analyses and alternative scenario analyses.
Results
Secukinumab achieved highest QALYs (13.1) at lowest expected lifetime cost (€279,872) vs other comparators in biologic-naïve AS patients in the base case analysis, thus it dominated other biologics. Golimumab had a second highest QALYs (12.9) at the total cost of €309,551. Results were sensitive to variation in BASDAI 50 response for secukinumab, baseline Bath Ankylosing Spondylitis Functional Index (BASFI) score across all drugs, change in BASDAI and BASFI scores, and discount rates as observed in the one-way sensitivity analyses. Secukinumab was either dominant or cost-effective treatment in different alternative scenarios.
Conclusion
Secukinumab presented itself to be the dominant (ie, less costly and more effective) treatment vs other comparators for the biologic-naïve patients with AS in Finland.
Acknowledgments
The authors thank Kavita Rodha and Niraj Modi (Novartis Healthcare Private Limited, Hyderabad, India) for editorial writing support. This study was funded by Novartis Pharma AG, Basel, Switzerland.
Author contributions
All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
TP is a full-time employee of Novartis Finland Oy, Espoo, Finland. KP receives honoraria from Abbvie, Bristol-Myers Squibb, Lilly, MSD, Novartis, Pfizer, Roche, Sandoz, and UCB; and congress trips from Abbvie and Pfizer outside the submitted work. DM and PG are full-time employees of Novartis Product Lifecycle Services-NBS, Novartis Health-care Private Limited, Hyderabad, India. JM is a founding partner of ESiOR Oy, which provides health economic, outcome research, and market access services for pharmaceutical and medical companies, as well as hospitals and other health and social care providers. The authors report no other conflicts of interest in this work.