Cost utility analysis based on a head-to-head Phase 3 trial comparing ustekinumab
and etanercept in patients with moderate-to-severe plaque psoriasis: a Canadian
Author(s): Pan F, Brazier NC, Shear NH, Jivraj F, Schenkel B, Brown R.
Affiliation(s): United BioSource Corporation, Bethesda, MD 20814, USA.
Publication date & source: 2011, Value Health. , 14(5):652-6
OBJECTIVE: A head-to-head comparator study has shown that the clinical efficacy
of ustekinumab is superior to that of etanercept over a 12-week period in
patients with psoriasis. Economic models are often hindered by the lack of trials
directly comparing outcomes between relevant alternative therapies. The aim of
this analysis was to evaluate the cost-effectiveness of ustekinumab versus
etanercept among adults with moderate-to-severe plaque psoriasis based on a Phase
3 head-to-head trial.
METHODS: The Markov model incorporates trial data from the Active Comparator
(CNTO 1275/Enbrel) Psoriasis Trial study (ustekinumab 45 mg at Weeks 0 and 4;
etanercept 50 mg biweekly) to follow patient response to initial treatment using
the modeling approach developed by the Centre for Reviews and Dissemination,
University of York, and often cited by others conducting economic analyses of
psoriasis. Beyond the initial trial period, the Canadian model extrapolates
results up to 10 years.
RESULTS: Over the 10-year time horizon of the model, the mean annual costs were
$16,807 for ustekinumab (45 mg) and $19,525 for etanercept (50 mg). The
incremental difference in costs and utilities remained in favour of ustekinumab
across a range of sensitivity analyses.
CONCLUSIONS: This model highlights the advantage of having head-to-head
comparative trial data relevant to the at-risk population. Our model shows that
ustekinumab is more cost-effective than etanercept for patients with
moderate-to-severe plaque psoriasis.