- •The efficacy and safety of targeted immunological therapy for patients with moderate-to-severe chronic plaque psoriasis has been robustly demonstrated. Nevertheless, biologics remain underutilized in the Philippines.
- •Most economic evaluations of biologics are from settings where other biologics are reasonable comparators. Our evaluation incorporates Philippine clinical practices that accommodate inadequate patient access to expensive treatments.
- •Ixekizumab and secukinumab both appear to be cost-effective treatments for biologic-naive patients with moderate-to-severe chronic plaque psoriasis, relative to methotrexate and the other interleukin inhibitors included in the study.
- •Subsidizing secukinumab treatment would be more expensive to a Government of the Philippines payer than similar subsidies for methotrexate.
- Roda A.R.
- Feldman S.R.
Patient Population and Interventions
- Reich K.
- Armstrong A.W.
- Foley P.
- et al.
- Robinson S.
- Moon T.M.
- Zhenli K.
- et al.
- Robinson S.
- Moon T.M.
- Zhenli K.
- et al.
Cost-Effectiveness of ILIs
Republic of the Philippines Department of Health - Health Technology Assessment Unit.
Budget impact of SEC
|Treatment||Cost per capita, PHP||PASI 75 responses||ICER (per response gained)||CE rank|
|GUS||2 232 843.55||3999||600 827.10||4|
|IXE||1 661 326.30||3720||468 098.01||1|
|SEC||1 812 283.09||3935||483 525.34||2|
|UST||1 990 689.66||3857||551 512.06||3|
|Scenario||Description||Five-year budget impact, PHP||Net budget impact relative to base case, PHP|
|Base case: ScM||Payer fully funds all treatment costs for MTX only and pays the case rate for inpatient treatment of SAEs.||123 209 677.84||Reference|
|ScS||Payer fully funds all treatment costs for SEC only and pays the case rate for inpatient treatment of SAEs.||1 953 378 856.19||1 830 169 178.36|
|ScMS||Payer fully funds all treatment costs for both MTX and SEC and pays the case rate for inpatient treatment of SAEs.||2 044 580 567.11||1 921 370 889.28|
|ScMS-F||Same as ScMS, but some patients who discontinue with MTX shift to SEC.||2 391 428.210.84||2 268 218 533.00|
|ScMS-FV||Same as ScMS-F, with accounting for market share value growth of SEC.||2 399 540 462.57||2 276 330 784.73|
|Combinations||Budget impact, PHP|
|MTX||SEC||SAE||SEC subsidy, %||SEC coverage, %|
|Base case: ScM||11 076||0||213||0||0||123 209 677.84||Reference|
|0||630||213||10||10||51 167 707.30||−72 041 970.53|
| Highest affordable|
|108 810 469.39|
108 810 469.39
|−14 399 208.45|
−14 399 208.45
|ScMS||No affordable combinations for this scenario|
Article and Author Information
- Supplemental Material
- Atlas, prevalence of psoriasis.(Global Psoriasis)
- Psoriasis. Nat Rev Dis Prim. 2016; 2: 1-17
- Prevalence of psoriasis phenotypes among men and women in the USA.Clin Exp Dermatol. 2016; 41: 486-489
- Pathogenesis and clinical features of psoriasis.Lancet. 2007; 370: 263-271
- Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.Cochrane Database Syst Rev. 2017; : CD011535
- Demographic and clinical profiles of adult Filipino patients with psoriasis in Davao City: a cross sectional study.J Phil Dermatol Soc. 2018; 27: 41-63
- Resolution Urging the Philippine Health Insurance Corporation (PhilHealth) to include Psoriasis in the List of Diseases and Ailments covered by its healthcare program, with the end in view of making psoriasis treatment available, especially to the margins, HR00719, 17th Congress, 1st Session. Republic of the Philippines House of Representatives, Quezon City.https://hrep-website.s3.ap-southeast-1.amazonaws.com/legisdocs/basic_17/HR00719.pdfDate accessed: March 24, 2022
- Philippine national drug formulary: essential medicines list. 8th edition. Republic of the Philippines Department of Health Pharmaceutical Division.
- Pushing psoriasis as a public health program. HEALTHbeat.July-October. 2010https://doh.gov.ph/sites/default/files/publications/HBEAT60a.pdfDate accessed: March 24, 2022
- Treatment of psoriasis in adults. UpToDate.
- Public summary: secukinumab; Cosentyx®. Novartis Pharmaceuticals Australia Pty Ltd.
- Secukinumab for treating moderate to severe plaque psoriasis. National Institute for Clinical Excellence (NICE).
- Single technology appraisal: guselkumab for treating active psoriatic arthritis after inadequate response to DMARDs. National Institute for Health and Care Excellence.https://www.nice.org.uk/guidance/ta815/resources/guselkumab-for-treating-active-psoriatic-arthritis-after-inadequate-response-to-dmards-pdf-82613312034757Date accessed: August 19, 2022
- Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (CHAMPION).Br J Dermatol. 2008; 158: 558-566
- Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: results from the phase III, double-blind, placebo- and active comparator–controlled VOYAGE 2 trial.J Am Acad Dermatol. 2017; 76: 418-431
- Phase 3 trials of ixekizumab in moderate-to-severe plaque psoriasis.N Engl J Med. 2016; 375: 345-356
- Secukinumab in plaque psoriasis - results of two phase 3 trials.N Engl J Med. 2014; 371: 326-338
- Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2).Lancet. 2008; 371: 1675-1684
- A new cost-effectiveness framework for modeling psoriasis treatments.Value Health. 2015; 18: A20
- Etanercept and efalizumab for the treatment of adults with psoriasis.Health Technol Assess. 2006; (2006;103:10(46):38.): 38
- The importance of disease associations and concomitant therapy for the long-term management of psoriasis patients.Arch Dermatol Res. 2007; 298: 309-319
- A cost comparison of treatments of moderate to severe psoriasis.Drug Benefit Trends. 2005; 17: 200-214
- Decision for biological treatment in real life is more strongly associated with the Psoriasis Area and Severity Index (PASI) than with the Dermatology Life Quality Index (DLQI).J Eur Acad Dermatol Venereol. 2015; 29: 452-456
- Exploring the relationship between EQ-5D, DLQI and PASI, and mapping EQ-5D utilities: a cross-sectional study in psoriasis from Hungary.Eur J Heal Econ. 2014; 15: 111-119
- Psoriasis Area Severity Index (PASI) and the Dermatology Life Quality Index (DLQI): the correlation between disease severity and psychological burden in patients treated with biological therapies.J Eur Acad Dermatol Venereol. 2014; 28: 333-337
- Psoriasis patients with Psoriasis Area and Severity Index (PASI) 90 response achieve greater health-related quality-of-life improvements than those with PASI 75-89 response: results from two phase 3 studies of secukinumab.J Dermatol Treat. 2017; 28: 492-499
- Reporting adverse drug reactions: definitions of terms and criteria for their use. Council for International Organizations of Medical Sciences (CIOMS).
- Cost-effectiveness of treatment with etanercept for psoriasis in Sweden.Eur J Heal Econ. 2012; 13: 145-156
- Cost-effectiveness of secukinumab as first biologic treatment, compared with other biologics, for moderate to severe psoriasis in Germany.J Eur Acad Dermatol Venereol. 2018; 32: 2191-2199
- Effectiveness and safety of secukinumab for psoriasis in a real-world clinical setting in the Asia-Pacific and Middle East Regions: results from the REALIA study.Dermatol Ther. 2022; 12: 511-527
- Estimating transition probabilities from published evidence: a tutorial for decision modelers.Pharmacoeconomics. 2020; 38: 1153-1164
- Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics.J Am Acad Dermatol. 2019; 80: 1029-1072
- Joint AAD-NPF guidelines of care for the management of psoriasis with systemic non-biological therapies.J Am Acad Dermatol. 2020; 82: 1445-1486
- Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with phototherapy.J Am Acad Dermatol. 2019; 81: 775-804
- Ustekinumab: indication, dosage, side effect, precaution. MIMS Philippines.
- Scapho full prescribing information, dosage & side effects. MIMS Philippines.
- Ixekizumab: indication, dosage, side effect, precaution. MIMS Philippines.
- The 2021 Philippine Drug Price Reference Index, 9th edition. Republic of the Philippines Department of Health – Pharmaceutical Division.
- The Tenth Report of the Malaysian Psoriasis Registry, 2007-2018. DermWeb.
- Updated population projections based on the 2015 census of population and housing (POPCEN). Philippine Statistics Authority.
- National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study.BMJ. 2020; 369: m1590
- Patient-reported reasons for the discontinuation of commonly used treatments for moderate to severe psoriasis.J Am Acad Dermatol. 2013; 68: 64-72
- Characterization of disease burden, comorbidities, and treatment use in a large, US-based cohort: results from the Corrona Psoriasis Registry.J Am Acad Dermatol. 2018; 78: 323-332
- GDP per capita (current US$) - Philippines. DataBank. The World Bank Group.
- Republic of the Philippines Department of Health - Health Technology Assessment Unit.https://hta.doh.gov.ph/philippine-hta-methods-guide/#:∼:text=The%20Philippine%20HTA%20Methods%20Guide%20is%20an%20annex%20of%20the,support%20of%20Universal%20Health%20Care%E2%80%9DDate accessed: March 23, 2022
User licenseCreative Commons Attribution (CC BY 4.0) |
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article
- Reuse portions or extracts from the article in other works
- Sell or re-use for commercial purposes
Elsevier's open access license policy