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Cost-effectiveness analysis of biologic sequential treatments for moderate-to-severe psoriasis: A Malaysian healthcare system perspective

Author

Listed:
  • Nor Azmaniza Azizam
  • Mofakhar Hussain
  • Eric Nauenberg
  • Wei Chern Ang
  • Amirah Azzeri
  • Jacob Smith

Abstract

Objective: In Malaysia, there is now a dearth of recommendations pertaining to the priority of biologic treatments for the effective management of psoriasis, given the multitude of available therapeutic alternatives. Present analysis reports results of a cost-effectiveness model that determines the most optimal arrangement of biologic treatments, with a particular focus of adding biosimilars to the existing treatment pathway for psoriasis in Malaysia. Methods: A Markov model was developed to compare the cost effectiveness of various biologic sequential treatments in a hypothetical cohort of moderate to severe psoriasis patient in Malaysia over a lifetime horizon. The model simulated the progression of patients through three lines of active biologic therapy, before transitioning to best supportive care. Costs and effects were discounted annually at a rate of 3%. Results: First line secukinumab has produced lowest incremental cost effectiveness ratios (ICERs) when compared to first line systemic [ICERs value; US$152,474 (first set analysis) and US$110,572 (second set analysis)] and first line phototherapy [ICERs value; US$147,057 (first set analysis) and US$107,616 (second set analysis)]. However, these values were slightly higher than the Malaysian based threshold of three times gross domestic product per capita, US$104,337. A 40% reduction in the unit costs of reference biologics renders most of the evaluated treatment sequences cost-effective. Conclusion: Adding biosimilar to the current treatment sequence could achieve cost savings ranging from 4.3% to 10.8% without significant loss of effectiveness. Given the significant impact of comorbidities and the resulting decline in quality of life among individuals with psoriasis, it may be justifiable to establish a threshold of up to US$184,000 per quality-adjusted life year (QALY) for the provision of therapies in the context of Malaysia.

Suggested Citation

  • Nor Azmaniza Azizam & Mofakhar Hussain & Eric Nauenberg & Wei Chern Ang & Amirah Azzeri & Jacob Smith, 2024. "Cost-effectiveness analysis of biologic sequential treatments for moderate-to-severe psoriasis: A Malaysian healthcare system perspective," PLOS ONE, Public Library of Science, vol. 19(9), pages 1-33, September.
    • Handle: RePEc:plo:pone00:0307234
    DOI: 10.1371/journal.pone.0307234
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    References listed on IDEAS

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    1. April W Armstrong & Clayton Schupp & Julie Wu & Bruce Bebo, 2012. "Quality of Life and Work Productivity Impairment among Psoriasis Patients: Findings from the National Psoriasis Foundation Survey Data 2003–2011," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-6, December.
    2. Alison Pearce & Paul Hanly & Aileen Timmons & Paul Walsh & Ciaran O’Neill & Eleanor O’Sullivan & Rachael Gooberman-Hill & Audrey Thomas & Pamela Gallagher & Linda Sharp, 2015. "Productivity Losses Associated with Head and Neck Cancer Using the Human Capital and Friction Cost Approaches," Applied Health Economics and Health Policy, Springer, vol. 13(4), pages 359-367, August.
    3. Matthijs M. Versteegh & Isaac Corro Ramos & Nasuh C. Buyukkaramikli & Amir Ansaripour & Vivian T. Reckers-Droog & Werner B. F. Brouwer, 2019. "Severity-Adjusted Probability of Being Cost Effective," PharmacoEconomics, Springer, vol. 37(9), pages 1155-1163, September.
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