Cost per Responder Analysis of Biologics in Moderate-to-severe Plaque Psoriasis in Indian Healthcare Setting

Abstract

Background: Moderate-to-severe plaque psoriasis (PsO) affects >8 million Indians and has a detrimental effect on quality of life (QoL). Effective skin clearance can be one of the important factors for improving patient’s QoL. Newer biologics offer significant levels of skin clearance eventually improving QoL. However high cost of origi-nator biologics is an impediment and poses a challenge for healthcare stakeholder to choose more efficacious and cost-effective biologic among the available options. Aims: To estimate the annual cost per responder (CPR) in PsO patients in India based on Psoriasis Area Severity Index (PASI)-75/90 for 52-weeks of treatment and estimate the number needed to treat (NNT). Methods: CPR has been developed to compare direct medical costs. The tool enables the user to input epidemiology numbers, level of drug usage and allows user to decide the biologic to choose to offer better health out-comes. Efficacy for biologics under evaluation were re-ported from the network meta-analysis and measured as proportion of patients achieving PASI-75/90 at week-52. NNT to obtain one patient with a PASI-75/90 response was henceforth calculated. Results: The tool demonstrates CPR and NNT results dy-namically with user provided inputs. Additional number of responders who could potentially be treated with the biologic under consideration with the annual cost-sav-ings generated were also presented. This will help users to assess comparative effectiveness of a biologic interven-tion by combining clinical and economic dimensions. Conclusion: This CPR tool supports evidence-based decision making for improved health outcomes in the Indian healthcare setting. Conclusion: This CPR tool supports evidence-based decision making for improved health outcomes in the Indian healthcare setting.