Background Secukinumab is a monoclonal antibody designed to recognise and attach to a messenger molecule in the immune system called interleukin 17A, whereas ustekinumab is also a monoclonal antibody which attaches to two cytokines called interleukin 12 and interleukin 23. All these cytokines are involved in the inflammation and other immune system processes that cause psoriasis. By blocking their activity, secukinumab and ustekinumab reduce the activity of the immune system and the symptoms of the disease.
Purpose To estimate the cost-comparison of secukinumab and ustekinumab following inadequate response to biologic drugs in patients with moderate to severe plaque psoriasis.
Material and methods Cost evaluation of psoriasis patients treated with secukinumab and ustekinumab following inadequate response to sdalimumab or etanercept in a third-tier hospital for 2 years (2015 to 2017).
The increase or decrease of costs were analysed when moving from one biological therapy to another.
We also studied how many naive patients started with secukinumab or ustekinumab as their first line of treatment.
Results A total of 43 and 58 patients were treated with adalimumab and etanercept respectively: nine patients had inadequate response to adalimumab and 16 patients to etanercept.
Thirteen patients were treated with Secukinumab: seven patients had inadequate response to etanercept, one patient to adalimumab and three patients to ustekinumab. Only two patients treated with secukinumab were naive.
The change from etanercept to secukinumab, adalimumab to secukinumab and ustekinumab to secukinumab caused a cost increase of €11,357/year, €2,232/year and €6,762/year respectively.
Thirty patients were treated with ustekinumab: nine patients had inadequate response to etanercept, eight patients to adalimumab and one patient to secukinumab. Twenty-two patients treated with ustekinumab were naive.
The change from etanercept to ustekinumab, adalimumab to ustekinumab and secukinumab to ustekinumab had a cost reduction of €5,683 €/year, €178€/year and €2,254/year respectively.
Al these changes of biological therapies have increased the hospital budget by about €12,236/year.
Conclusion Ustekinumab provides the best cost for psoriasis in this study.
Furthermore, its administration is more comfortable for patients because ustekinumab is given every 12 weeks while secukinumab is given in two injections every 4 weeks.
Ustekinumab could also represent a treatment opportunity for patients’ non-adherence.
References and/or Acknowledgements Data sheet Ustekinumab, Secukinumab.
Guía de manejo Psoriasis.
No conflict of interest
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