A real-world economic analysis of biologic therapies for moderate-to-severe plaque psoriasis in Italy: results of the CANOVA observational longitudinal study

BMC Health Services Research

Silvana Ruffolo¹  Eugenio Provenzano¹  Paolo Dapavo²  Michela Ortoncelli²  Matteo Megna³  Andrea Conti⁴  Salvatore Corrao⁵  Massimo Raspanti⁵  Martina Burlando⁶  Aurora Parodi⁶  Giovanni Pellacani⁷  Katharina Hansel⁸  Luca Stingeni⁸  Matteo Paolinelli⁹  Annamaria Offidani⁹  Alina De Rosa^1,10  Giuseppe Argenziano^1,10  Maria Concetta Fargnoli^1,11  Rosaria Fidanza^1,11  Federico Bardazzi^1,12  Marco Adriano Chessa^1,12  Chiara Moltrasio^1,13  Carlo Carrera^1,13  Clara De Simone^1,14  Ketty Peris^1,14  Antonio Costanzo^1,15  Alessandra Narcisi^1,15  Francesca Maria Gaiani^1,16  Piergiorgio Malagoli^1,16  Lucia Simoni^1,17  Alessandro Zullo^1,17  Delia Colombo^1,18  Emanuela Zagni^1,18  Martina Fiocchi^1,18  Luca Bianchi^1,19  Marina Talamonti^1,19  Gabriella Fabbrocini^2,20  Marco Romanelli^2,21  Annalisa Tonini^2,21 

[1] A.O. Cosenza Ospedale SS Annunziata, Cosenza, Italy;A.O.U. Città della Salute e della Scienza PO Molinette, Turin, Italy;A.O.U. Federico II, Naples, Italy;A.O.U. Policlinico, Modena, Italy;ARNAS Civico, Palermo, Italy;Clinica Dermatologica DiSSal Università di Genova/Ospedale-Policlinico San Martino IRCCS, Genoa, Italy;Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy;Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy;Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy;Dermatology Unit, University of Campania, Naples, Italy;Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy;Dermatology, IRCCS Policlinico di S Orsola Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy;Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy;Fondazione Policlinico Universitario A. Gemelli-IRCCS and Università Cattolica, Rome, Italy;IRCCS Istituto Clinico Humanitas, Rozzano, Italy;IRCCS Policlinico San Donato, San Donato Milanese, Italy;MediNeos Observational Research, Modena, Italy;Novartis Farma S.p.A, Largo Umberto Boccioni, 1, 21040, Origgio, Varese, Italy;Policlinico Tor Vergata, Rome, Italy;Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy;U.O. Dermatologia Universitaria - Azienda Ospedaliero Universitaria Pisana, Pisa, Italy;

关键词: Biologic;    Secukinumab;    Adalimumab;    Ustekinumab;    Ixekizumab;    Costs;    Cost per responder;    Response rate;    Real-world;   

DOI  :  10.1186/s12913-021-06866-7

来源: Springer

【 摘 要 】

BackgroundPsoriasis is a chronic immune-mediated inflammatory skin disease which can also involve joints. It is often associated with burdensome comorbidities which negatively impact prognosis and quality of life (QoL). Biologic agents have been shown to be effective in controlling disease progression, but their use is associated with higher costs compared with traditional systemic treatments. The economic analysis of the CANOVA (EffeCtiveness of biologic treAtmeNts for plaque psOriasis in Italy: an obserVAtional longitudinal study of real-life clinical practice) study aims to assess the costs and cost-effectiveness of biologics in a real-world context in Italy.MethodsThe annualised overall direct costs of moderate-to-severe plaque psoriasis management, the annualised cost of biologic drugs and the cost per responder in the Italian National Health System perspective were assessed. More specifically, the cost per response and cost per sustained response of the most prescribed biologic therapies for the treatment of moderate-to-severe plaque psoriasis within the CANOVA study were assessed using the Psoriasis Area Severity Index (PASI) at several score levels (75, 90 and 100%).ResultsThe most frequently used biologic therapies for plaque psoriasis were secukinumab, ustekinumab, adalimumab originator, and ixekizumab. Cost of biologics was the driver of expenditure, accounting for about 98% of total costs. Adalimumab originator was the biologic with the lowest cost per responder ratio (range: €7848 - €31,378), followed by secukinumab (range: €9015 - €33,419). Ustekinumab (range: €11,689 – €39,280) and ixekizumab (range: €11,092 – €34,289) ranked respectively third and fourth, in terms of cost-effectiveness ratio. As concerns the cost per sustained response analysis, secukinumab showed the lowest value observed (€21,375) over the other options, because of its high response rate (86% vs. 60–80%), which was achieved early in time.ConclusionBiologic therapy is a valuable asset for the treatment of moderate-to-severe plaque psoriasis. Concomitant assessment of treatment costs against the expected therapeutic response over time can provide physicians and payers additional insights which can complement the traditional risk-benefit profile assessment and drive treatment decisions.

【 授权许可】

CC BY