Cost-effectiveness of treatment with etanercept for psoriasis in Sweden

Eur J Health Econ. 2012 Apr;13(2):145-56. doi: 10.1007/s10198-010-0293-8. Epub 2011 Mar 6.

Abstract

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.

MeSH terms

  • Adalimumab
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / economics*
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / economics*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Cost-Benefit Analysis
  • Etanercept
  • Health Care Costs
  • Humans
  • Immunoglobulin G / administration & dosage
  • Immunoglobulin G / economics*
  • Immunoglobulin G / therapeutic use
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / economics*
  • Immunologic Factors / therapeutic use
  • Markov Chains
  • Psoriasis / drug therapy*
  • Psoriasis / economics*
  • Quality-Adjusted Life Years
  • Randomized Controlled Trials as Topic
  • Receptors, Tumor Necrosis Factor / administration & dosage
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Sweden
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Immunoglobulin G
  • Immunologic Factors
  • Receptors, Tumor Necrosis Factor
  • Adalimumab
  • Etanercept