Evaluating Costs of Biologic Drugs for the Treatment of Moderate-to-Severe Psoriasis in the United States

2019 ◽  
Vol 4 (3) ◽  
pp. 133-142
Author(s):  
Steven R. Feldman ◽  
Jashin J. Wu ◽  
April W. Armstrong ◽  
Mark Lebwohl ◽  
Abby A. Jacobson ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Treatment Cost ◽  
Severity Index ◽  
The United States ◽  
Severe Psoriasis ◽  
Biologic Drugs ◽  
Annual Treatment ◽  
The Cost ◽  
Annual Treatment Cost

Objective:To provide a contemporary comparative assessment of biologic drug costs and cost effectiveness for treating moderate-to-severe psoriasis in the United States.Methods:A literature search was conducted in PubMed on October 4, 2018 with the search terms of “psoriasis,” “biologic,” and “cost” with a filter of publication dates within the last 5 years (2014-2018). Studies included in this review were required to be conducted from a United States perspective.Results:Of the 16 studies retrieved, the costs associated with use of biologic drugs for the treatment of moderate-to-severe psoriasis were relatively high, with some drugs exhibiting sustained lower costs than others. Some comparative findings on the cost-effectiveness of biologic drugs based on the annual treatment cost per Psoriasis Area and Severity Index (PASI) 75 responder concluded that the annual treatment cost was lowest for brodalumab 210 mg at US$48 782; the cost was highest for ustekinumab 45/90 mg (US$87 243), followed by adalimumab 40 mg (US$82 655), ixekizumab 160 mg (US$77 957), and secukinumab 300 mg (US$75 671). The annual treatment cost per PASI 100 responder was also lowest for brodalumab at US$87 585. This pattern remained consistent in other cost studies, with brodalumab being the treatment with the lowest treatment costs when compared to other biologic drugs.Conclusion:Brodalumab was consistently observed to be the least costly treatment option among biologic drugs used to treat moderate-to-severe psoriasis in the United States, which is largely the result of its low-drug cost and high-PASI response rate.

Comparison of the cost-effectiveness of biologic drugs used for moderate-to-severe psoriasis treatment in the United States

2018 ◽  
Vol 29 (8) ◽  
pp. 769-774 ◽  
Author(s):  
Jashin J. Wu ◽  
Steven R. Feldman ◽  
Shipra Rastogi ◽  
Brandy Menges ◽  
Melissa Lingohr-Smith ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
The United States ◽  
Severe Psoriasis ◽  
Biologic Drugs ◽  
Psoriasis Treatment ◽  
The Cost

scholarly journals Evaluation of the cost-effectiveness of buprenorphine in treatment of chronic pain using competing EQ-5D weights

2015 ◽  
Vol 6 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Hanna Norrlid ◽  
Peter Dahm ◽  
Gunnel Ragnarson Tennvall
Keyword(s):  
Chronic Pain ◽  
Cost Effectiveness ◽  
Treatment Cost ◽  
Cost Effective ◽  
Elderly Persons ◽  
Physician Visits ◽  
Annual Treatment ◽  
The Uk ◽  
The Cost ◽  
Annual Treatment Cost

AbstractBackground and aimsChronic pain is a life altering condition and common among elderly persons. The 7-day buprenorphine patch could be a suitable treatment for managing chronic pain of moderate severity in elderly patients in Sweden.The objective of this analysis was to investigate the cost-effectiveness of the 7-day buprenorphine patch, versus no treatment, in patients >50 years old who suffer from moderate pain in a health economic perspective. An additional aim was to evaluate how the cost-effectiveness is affected by the choice of EQ-5D weights.MethodsThe annual treatment cost and the potential gains in health-related quality of life (HRQoL) of buprenorphine, compared to no treatment, were evaluated. Original EQ-5D data were collected from four clinical reference studies at baseline and at the final visit. Treatment effects on HRQoL were then assessed using both UK and Swedish EQ-5D weights. Annual treatment costs were calculated based on costs of physician visits and pharmaceuticals.The optimal treatment dose was 10-15 μg/h and the analysis was hence performed on both a 10- and a 15 μg/h buprenorphine patch.ResultsThe analysis of buprenorphine treatment resulted in improved HRQoL in all reference studies, irrespective of choice of EQ-5D weight set. The change in quality adjusted life years (QALYs) varied with a gain of 0.042-0.118 using the UK weights and 0.020-0.051 with the Swedish weights. The average annual treatment cost was SEK14454 for the 10μg/h patch and SEK17 017 for the 15 μg/h patch, while cost for the no-treatment alternative was SEK 9 960. The base case incremental cost-effectiveness ratios (ICER) with the UK weights were SEK 40000-SEK 170000 and SEK 90000-SEK 350000 when applying the Swedish weights. The corresponding ICER-span in the sensitivity analysis was SEK 15 000-SEK 400 000 when applying the UK weights and SEK 30 000-SEK 840 000 with the Swedish weights (SEK 100 is about €11).ConclusionsThe results imply that the 7-day buprenorphine patch may be a cost-effective treatment of moderate chronic pain in patients over 50 years of age. The UK and the Swedish EQ-5D weights generated vastly different HRQoL estimates but buprenorphine remains cost-effective regardless choice of weight set.

Estimating the Cost-Effectiveness of OnabotulinumtoxinA for Neurogenic Detrusor Overactivity in the United States

2013 ◽  
Vol 35 (4) ◽  
pp. 414-424 ◽  
Author(s):  
Josh J. Carlson ◽  
Ryan N. Hansen ◽  
Roger R. Dmochowski ◽  
Denise R. Globe ◽  
Danielle C. Colayco ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Detrusor Overactivity ◽  
The United States ◽  
Neurogenic Detrusor Overactivity ◽  
The Cost

scholarly journals The Cost-Effectiveness of Epilepsy Surgery and Surgical Evaluation in the United States

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Shehryar R Sheikh ◽  
Michael P Steinmetz ◽  
Michael W Kattan ◽  
Mendel Singer ◽  
Belinda Udeh ◽  
...  
Keyword(s):  
United States ◽  
Monte Carlo ◽  
Cost Effectiveness ◽  
Epilepsy Surgery ◽  
Medical Management ◽  
Cost Effective ◽  
The United States ◽  
Effective Strategies ◽  
Surgical Evaluation ◽  
The Cost

Abstract INTRODUCTION Surgery is an effective treatment for many pharmacoresistant temporal lobe epilepsy patients, but incurs considerable cost. It is unknown whether surgery and surgical evaluation are cost-effective strategies in the United States. We aim to evaluate whether 1) surgery is cost-effective for patients who have been deemed surgical candidates when compared to continued medical management, 2) surgical evaluation is cost-effective for patients who have drug-resistant temporal epilepsy and may or may not ultimately be deemed surgical candidates METHODS We use a Monte Carlo simulation method to assess the cost-effectiveness of surgery and surgical evaluation over a lifetime horizon. Patients transition between two health states (‘seizure free’ and ‘having seizures’) as part of a Markov process, based on literature estimates. We adopt both healthcare and societal perspectives, including direct healthcare costs and indirect costs such as lost earnings by patients and care providers. We estimate variability of model predictions using probabilistic and deterministic sensitivity analyses. RESULTS 1) Epilepsy surgery is cost effective in surgically eligible patients by virtue of being cost saving and more effective than medical management in the long run, with 95% of 10 000 Monte Carlo simulations favoring surgery. From a societal perspective, surgery becomes cost effective within 3 yr. At 5 yr, surgery has an incremental cost-effectiveness ratio (ICER) of $31,600, which is significantly below the societal willingness-to-pay (∼ $100,000/quality-adjusted life years (QALY)) and comparable to hip/knee arthroplasty. 2) Surgical evaluation is cost-effective in pharmacoresistant patients even if the probability of being deemed a surgical candidate is low (5%-10%). Even if the probability of surgical eligibility is only 10%, surgical referral has an ICER of $96,000/QALY, which is below societal willingness-to-pay. CONCLUSION Epilepsy surgery and surgical evaluation are both cost-effective strategies in the United States. Pharmacoresistant temporal lobe epilepsy patients should be referred for surgical evaluation without hesitation on cost-effectiveness grounds.

The cost-effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States

Addiction ◽  
2001 ◽  
Vol 96 (9) ◽  
pp. 1267-1278 ◽  
Author(s):  
Paul G. Barnett ◽  
Gregory S. Zaric ◽  
Margaret L. Brandeau
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Maintenance Therapy ◽  
The United States ◽  
Opiate Addiction ◽  
The Cost
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