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Earlier intervention with TNF inhibitors seen as more cost-effective for patients with PsA

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Patients with psoriatic arthritis who had both skin and joint involvement benefited from early use of a tumor necrosis factor inhibitor, but at a higher cost overall. However, costs were lower for some patients who responded quickly to treatment, according to recently presented data.

Vibeke Strand, MD, and colleagues developed a Markov model to evaluate costs and outcomes of treatments with tumor necrosis factor inhibitors (TNFi) adalimumab, etanercept, infliximab or golimumab and/or apremilast for patients with psoriatic arthritis based on results from randomized controlled trials and market share data. Included patients were classified as either “timely TNFi” as initial treatment or “delayed TNFi” if they were first treated with apremilast (Otezla, Celgene). Joint and skin involvement were evaluated.

Vibeke Strand

A higher ACR20 response rate, lower number needed-to-treat to see one responder to treatment and higher costs were observed among patients classified as timely TNFi recipients (70% ACR20 response; $39,745) compared to delayed use (60% ACR response; $31,513). Both higher ACR20 and psoriasis area and severity index 75% improvements were observed for patients with moderate to severe psoriasis who received timely TNFi therapy compared to delayed TNFi treatment, but these patients also had higher costs at $41,437 vs. $33,510, respectively. However, the cost among all patients with psoriasis was higher among ACR20 responders ($56,492 vs. $52,835) but lower per responder in timely TNFi use patients who had both ACR20 and PASI75 responses at $100,954 compared to $111,686, respectively. – by Shirley Pulawski

Reference:

Strand V, et al. Paper #2526. Presented at: American Academy of Dermatology 74th Annual Meeting; March 4-8, 2016; Washington, D.C.

Disclosure: Strand is a consultant to AbbVie, Alder, Amgen, BMS, Celgene, Genentech,

Janssen, Novartis, Pfizer and UCB; and has served on advisory boards for AbbVie, Amgen, BMS, Celgene, Genentech, Janssen, Novartis, Pfizer and UCB.