Real-world Cost per Responder Among Different Classes of Biologics for the Treatment of Psoriasis

Authors

  • Linda T.H. Godding Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
  • Marieke M.B. Seyger Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
  • Albert Duvetorp Leo Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Department of Dermatology Malmö, Skåne University Hospital, Region Skåne, Malmö, Sweden
  • Marisol E. Otero Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
  • Paul M. Ossenkoppele Department of Dermatology, Ziekenhuisgroep Twente, Almelo/Hengelo, The Netherlands
  • Annet M. Oostveen Department of Dermatology, Gelre Ziekenhuizen, Apeldoorn/Zutphen, The Netherlands
  • M. Birgitte Visch Department of Dermatology, Ziekenhuis Rijnstate, Arnhem, The Netherlands
  • Ella A.M. van der Voort Department of Dermatology/dermaTeam Research, Bravis, Bergen op Zoom, The Netherlands
  • John E.M. Körver Department of Dermatology, Amphia ziekenhuis, Breda, The Netherlands
  • Lizelotte J.M.T. Weppner-Parren Department of Dermatology, Jeroen Bosch Ziekenhuis, ’s-Hertogenbosch, The Netherlands
  • Maartje A.M. Berends Department of Dermatology, Slingeland Ziekenhuis, Doetinchem, The Netherlands
  • W. Peter Arnold Department of Dermatology, Ziekenhuis Gelderse Vallei, Ede, The Netherlands
  • Sharon R.P. Dodemont Department of Dermatology, Catharina Ziekenhuis, Eindhoven, The Netherlands
  • Astrid L.A. Kuijpers Department of Dermatology, Máxima MC, Eindhoven, The Netherlands
  • Johannes M. Mommers Department of Dermatology, Anna Ziekenhuis, Geldrop, The Netherlands
  • Femke M. Homan Department of Dermatology, Ziekenhuisgroep Twente, Almelo/Hengelo, The Netherlands
  • Antoni H. Gostynski Department of Dermatology, Maastricht University Medical Centre, Maastricht, The Netherlands; GROW, Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
  • Berit Velstra Department of Dermatology, St Antonius Ziekenhuis, Nieuwegein, The Netherlands
  • Marloes M. Kleinpenning Department of Dermatology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
  • Martijn B.A. van Doorn Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
  • Romy R.M.C. Keijsers Department of Dermatology, Zuyderland Medisch Centrum, Sittard-Geleen/Heerlen, The Netherlands
  • Else N. Kop Department of Dermatology, Bernhoven, Uden, The Netherlands
  • Inge M. Haeck Department of Dermatology, Utrecht Medisch Centrum, Utrecht, The Netherlands
  • Judith H.J. Hendricksen-Roelofzen Department of Dermatology, Streekziekenhuis Koningin Beatrix, Winterswijk, The Netherlands
  • Douwe Vellinga Department of Dermatology, Alrijne hospital, Leiderdorp, The Netherlands
  • Elke M.G.J. de Jong Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
  • Juul M.P.A. van den Reek Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands

DOI:

https://doi.org/10.2340/actadv.v105.42767

Keywords:

Biologics, cost-effectiveness, cost per responder, observational studies, psoriasis, real-world evidence

Abstract

Although biologics have revolutionized psoriasis treatment, they pose a significant burden on the healthcare budget. With the wide range of biologics available and the increasing number of biosimilars, insights into the real-world cost per responder (CPR) are required. Therefore, this study aims to evaluate the real-world CPR of adalimumab, ustekinumab, IL17- and IL23-inhibitors, incorporating both relative (Psoriasis Area and Severity Index; PASI75/90/100) and absolute (PASI ≤ 3/ ≤ 1) responder definitions and real-world dose adjustments. Tildrakizumab and bimekizumab were excluded due to limited data. Using Dutch list prices and discounts on adalimumab’s and ustekinumab’s originator prices because of biosimilar availability, adalimumab showed the lowest 1-year CPR across all responder definitions. Among biologics without biosimilar availability, the lowest CPRs were seen for brodalumab and guselkumab. Overall, the cost-per-PASI ≤ 3-responder was, across all biologics, more homogeneous than the CPR based on relative PASIs. Similar patterns were seen when using Swedish prices, which are, in contrast to Dutch prices, transparent. The relevance of using real-world data, specifically with the use of absolute PASIs instead of relative PASIs, is shown in this study. Additionally, as price fluctuations have the biggest impact on cost-effectiveness, price transparency is essential to effectively guide physicians in selecting a cost-effective treatment strategy.

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2025-06-18

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Godding, L. T., Seyger, M. M., Duvetorp, A., Otero, M. E., Ossenkoppele, P. M., Oostveen, A. M., … van den Reek, J. M. (2025). Real-world Cost per Responder Among Different Classes of Biologics for the Treatment of Psoriasis. Acta Dermato-Venereologica, 105, adv42767. https://doi.org/10.2340/actadv.v105.42767

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Vol. 105 (2025)

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Copyright (c) 2025 Linda T.H. Godding, Marieke M.B. Seyger, Albert Duvetorp, Marisol E. Otero, Paul M. Ossenkoppele, Annet M. Oostveen, M. Birgitte Visch, Ella A.M. van der Voort, John E.M. Körver, Lizelotte J.M.T. Weppner-Parren, Maartje A.M. Berends, W. Peter Arnold, Sharon R.P. Dodemont, Astrid L.A. Kuijpers, Johannes M. Mommers, Femke M. Homan, Antoni H. Gostynski, Berit Velstra, Marloes M. Kleinpenning, Martijn B.A. van Doorn, Romy R.M.C. Keijsers, Else N. Kop, Inge M. Haeck, Judith H.J. Hendricksen-Roelofzen, Douwe Vellinga, Elke M.G.J. de Jong, Juul M.P.A. van den Reek

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