Budget Impact Model of Secukinumab for Psoriasis, Psoriatic Arthritis and Ankylosing Spondylitis Treatment in Italy

• Published in: Value in health 2017-10, Vol.20 (9), p.A529
• Main Authors: Naclerio, M, Colombo, GL, Di Matteo, S, Martinotti, C, Oselin, M, Bruno, GM
• Format: Article
• Language: English
• Subjects: Ankylosing spondylitis; Arthritis; Cost control; Cost reduction; Critical incidents; Health care expenditures; Health services; Immunosuppressive agents; Inflammation; Inflammatory diseases; Medical treatment; Monoclonal antibodies; Patients; Prices; Psoriasis; Psoriatic arthritis; Robustness; Savings; Sensitivity analysis; Spondylitis; Tariffs
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.738

OBJECTIVES: Psoriasis (PsO), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) are chronic, immune-mediate, inflammatory diseases associated with different comorbidities and worsening health-related QoL. In Italy approximately 35,377 PsO, PsA and AS patients are estimated to receive biological drugs in 2017. Secukinumab is a first-in-class recombinant, fully human 17A inhibitor.The objective of this study was to estimate the budget impact, up to 5-years, from the Italy National Health Service perspective, of introducing Secukinumab for the treatment of PsO, PsA and AS patients alongside major market comparators. METHODS: The 5-years budget impact model was developed, only direct medical cost were considered. Model implementation considered input data on eligible population, market shares, resource use and cost of items (drug therapy costs, administration costs, management diseases-related costs and adverse events costs) with and without the introduction of Secukinumab. Ex-factory list prices, Italian National Tariffs and data from published literature were applied. To assess the robustness of the model's results, a sensitivity analysis (10 % range of variables) was developed. RESULTS: Considering total direct medical costs, cumulative saving resulted in about 106 mEUR after 5 years from Secukinumab introduction. The largest cumulative cost savings was observed in AS patients with 67.7 mEUR In PsA and PsO patients saving estimates resulted in 32 mEUR and 6.3 mEUR, respectively. In the fifth-year the cost reduction per patient resulted in 2,050 EUR for AS, 609 EUR for PsA and 53 EUR for PsO. CONCLUSIONS: From the Italian NHS perspective, Secukinumab presents a cost-saving option for the treatment of PsA and AS, potentially increasing if used in biologic-naive PsA patients, while doesn't involve any rise in costs for the treatment of PsO. With the introduction of Secukinumab more patients could be treated more effectively with biologies in Italy under a given health budget due to the cost-offsets.