A Cross-Indication Budget Impact Model of Secukinumab for the Treatment of Psoriasis, Psoriatic Arthritis, Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis in Italy

Paolo Angelo Cortesi; Carla Fornari; Paolo Gisondi; Florenzo Iannone; Ippazio Cosimo Antonazzo; Elisabetta Aloisi; Martina Fiocchi; Daniela Ritrovato; Lorenzo Giovanni Mantovani

doi:10.1007/s41669-023-00404-3

A Cross-Indication Budget Impact Model of Secukinumab for the Treatment of Psoriasis, Psoriatic Arthritis, Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis in Italy

Pharmacoecon Open. 2023 May;7(3):405-416. doi: 10.1007/s41669-023-00404-3. Epub 2023 Mar 16.

Authors

Paolo Angelo Cortesi¹, Carla Fornari², Paolo Gisondi³, Florenzo Iannone⁴, Ippazio Cosimo Antonazzo¹, Elisabetta Aloisi⁵, Martina Fiocchi⁵, Daniela Ritrovato⁵, Lorenzo Giovanni Mantovani^{1

6}

Affiliations

¹ Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy.
² Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy. [email protected].
³ Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
⁴ DETO, Rheumatology Unit, University of Bari, Policlinico, Bari, Italy.
⁵ Novartis Farma SpA, Origgio, Italy.
⁶ Value Based Healthcare Unit, IRCCS Multimedica, Sesto San Giovanni, Italy.

Abstract

Background: Recent developments improved outcomes in patients with autoimmune diseases. Biologics were approved as first-line treatment in selected naïve patients with plaque psoriasis (PsO), psoriatic arthritis (PsA), ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). Among them, secukinumab was most recently approved for treatment of active nr-axSpA in adults. In this work, we assessed the budget impact of new secukinumab treatment options in the Italian market.

Methods: A cross-indication budget impact model was designed to estimate the effects of adding secukinumab in the Italian market from the National Health System perspective over a 3-year period. The model included all adults with PsO, PsA, AS and nr-axSpA, treated with biologics or biosimilars. It compared costs between two scenarios, secukinumab availability or absence, for the four diseases combined and taken individually. A sensitivity analyses was conducted.

Results: There were 68,121 adult patients treated with biologics in 2021 and 68,341 in 2023. The budget impact analysis (BIA) on all indications showed a cost reduction of €33.7 million (- 1.5%) over 3 years with the introduction of secukinumab. PsA patients had the highest saving (- €34.9 million), followed by PsO patients (- €7.8 million). Cost saving in PsO patients was balanced by increased budget reported in AS patients (+ €8.0 million). In nr-axSpA patients, secukinumab reported no significant budget increase (+ 1.0%).

Conclusion: This BIA accounted for the new indication of secukinumab in nr-axSpA patients, reporting no significant changes in the required budget and adding an effective treatment option. Considering all indications, secukinumab is a sustainable treatment option.