Long-term cost-effectiveness analysis of etanercept and adalimumab for plaque psoriasis not associated with arthritis

Introduction: Pharmacoeconomic studies examining the cost-effectiveness of biological agents to treat moderate-to-severe psoriasis in real-life clinical practice are scarce. The aim of this study was to assess the efficiency, in terms of incremental cost-effectiveness, of etanercept and adalimumab in a real clinical setting. Methods: Direct and indirect costs were assessed froma Spanish societal perspective in a historical hospital cohort of patients with moderate-tosevere psoriasis attending a tertiary referral hospital over a 1-year period. The data examined included drug-related variables, use of health-care resources, transportation and work productivity losses. Effectiveness wasmeasured as the proportion of patients achieving a reduction of at least 75% with respect to the baseline value for the Psoriasis Area Severity Index (PASI 75) during the first 52 weeks of treatment. Results: No statistically significant differences in effectiveness between etanercept (n = 135) and adalimumab (n = 48) were found (PASI 75 80% vs. 85.7%; RR = 1.07 [0.90, 1.27]; RRA = 5.7 [-8.9, 20.2]; p = 0.943). There were no significant differences in total cost per patient with etanercept as compared to adalimumab (14,843.73 ± 6,178.98 € vs. 15,405.91 ± 9,106.50 €; p = 0.768). Conclusion: Under conditions of daily clinical practice in our hospital, total health-care costs associated with the treatment of moderate-tosevere psoriasis with etanercept appear to be equivalent to those with adalimumab in the first year of treatment. © The Author(s) 2013.