OBJECTIVE: To estimate the cost-effectiveness, from a Swedish societal perspective, of intermittent use of etanercept (Enbrel) with interruptions of use after 24 weeks compared to continuous use of adalimumab (Humira) as well as non-systemic standard of care in patients with moderate to severe psoriasis. METHODS: A Markov decision-tree model was constructed from clinical trials results. Patients starting etanercept, adalimumab, or non-systemic therapy moved through the model's 10-years horizon. Model input parameters included clinical response rates. Outcome measures included direct and indirect costs and quality-adjusted life-years (QALYs). RESULTS: The incremental total (direct and indirect) costs per QALY were 1,559,939 kr (<euro>165,354) for adalimumab 40 mg every other week, compared with intermittent once-weekly Enbrel 50 mg, and 93,629 kr (<euro>9,925) for once-weekly intermittent etanercept 50 mg compared with non-systemic standard of care. CONCLUSIONS: This analysis showed that, with a 470,000 kr (<euro>50,000) per QALY willingness-to-pay threshold, once-weekly etanercept 50 mg, used intermittently, is a cost-effective treatment for moderate to severe psoriasis compared with adalimumab and non-systemic standard of care.
OBJECTIVE: To estimate the cost-effectiveness, from a Swedish societal perspective, of intermittent use of etanercept (Enbrel) with interruptions of use after 24 weeks compared to continuous use of adalimumab (Humira) as well as non-systemic standard of care in patients with moderate to severe psoriasis. METHODS: A Markov decision-tree model was constructed from clinical trials results. Patients starting etanercept, adalimumab, or non-systemic therapy moved through the model's 10-years horizon. Model input parameters included clinical response rates. Outcome measures included direct and indirect costs and quality-adjusted life-years (QALYs). RESULTS: The incremental total (direct and indirect) costs per QALY were 1,559,939 kr (<euro>165,354) for adalimumab 40 mg every other week, compared with intermittent once-weekly Enbrel 50 mg, and 93,629 kr (<euro>9,925) for once-weekly intermittent etanercept 50 mg compared with non-systemic standard of care. CONCLUSIONS: This analysis showed that, with a 470,000 kr (<euro>50,000) per QALY willingness-to-pay threshold, once-weekly etanercept 50 mg, used intermittently, is a cost-effective treatment for moderate to severe psoriasis compared with adalimumab and non-systemic standard of care.
Authors: N Woolacott; Y Bravo Vergel; N Hawkins; A Kainth; Z Khadjesari; K Misso; K Light; C Asseburg; S Palmer; K Claxton; I Bruce; M Sculpher; R Riemsma Journal: Health Technol Assess Date: 2006-09 Impact factor: 4.014
Authors: Andrew A Nelson; Daniel J Pearce; Alan B Fleischer; Rajesh Balkrishnan; Steven R Feldman Journal: J Am Acad Dermatol Date: 2007-11-08 Impact factor: 11.527
Authors: K A Papp; S Tyring; M Lahfa; J Prinz; C E M Griffiths; A M Nakanishi; R Zitnik; P C M van de Kerkhof; Linda Melvin Journal: Br J Dermatol Date: 2005-06 Impact factor: 9.302
Authors: Kenneth B Gordon; Alice B Gottlieb; Craig L Leonardi; Boni E Elewski; Andrea Wang; Angelika Jahreis; Ralph Zitnik Journal: J Dermatolog Treat Date: 2006 Impact factor: 3.359
Authors: Juan Ruano; Beatriz Isla-Tejera; Rafael Jiménez-Puya; Ana Rodriguez-Martin; Manuel Cárdenas; Francisco Gómez; A Antonio Vélez; José R Del Prado-Llergo; José C Moreno-Giménez Journal: Dermatol Ther (Heidelb) Date: 2013-07-06