Number Needed to Treat and Associated Costs Per Additional Responder of Biologic Therapies in Adult Patients With Moderate To Severe Atopic Dermatitis
Author(s)
Jules TAVI, MSc, PharmD1, Kerry Noonan, BA2, Andreas Kuznik, PhD3, Zhixiao Wang, PhD3.
1Sanofi, Gentilly, France, 2Sanofi, Cambridge, MA, USA, 3Regeneron Pharmaceuticals, Inc., Sleepy Hollow, NY, USA.
1Sanofi, Gentilly, France, 2Sanofi, Cambridge, MA, USA, 3Regeneron Pharmaceuticals, Inc., Sleepy Hollow, NY, USA.
OBJECTIVES: Dupilumab, tralokinumab and lebrikizumab are the currently approved biologic therapies for patients with moderate-to-severe atopic dermatitis (AD) ineligible or with an inadequate response to topical therapies in the United States (US). The current analysis compared the number needed-to-treat (NNT) and the costs per additional responder (CPR) in adult patients with moderate-to-severe AD treated with these biologic therapies, from a US payer perspective.
METHODS: Based on comparative efficacy data from Silverberg et al. (2021) and from Guyot et al (2024) on systemic AD therapies, an Excel model was developed to estimate the NNT and incremental CPR per year. The model compared dupilumab, tralokinumab, and lebrikizumab in combination with topical therapy over a 16-week treatment period. Response to treatment was defined as a 75% reduction from the baseline in Eczema Area and Severity Index (EASI-75) at Week 16. NNT was calculated as the inverse of the absolute risk reduction versus standard of care for each biologic. Current US list prices based on RED BOOK (IBM Micromedex, 2024) were used for the drugs. Sensitivity analyses were done based on the drug price variation for tralokinumab and lebrikizumab.
RESULTS: The NNT to achieve one additional responder was lower with dupilumab versus tralokinumab (3 versus 4) and lebrikizumab (3 versus 6), respectively, considering EASI-75 as the response measure. The CPR/year to achieve EASI-75 was higher for tralokinumab ($61.4K versus $45.6K) and lebrikizumab ($92.1K versus $45.6K) versus dupilumab. These results were consistent in the sensitivity analyses.
CONCLUSIONS: Dupilumab demonstrated a lower NNT and approximately 1.5- and 2-times lower CPR/year, compared to tralokinumab and lebrikizumab, respectively. Dupilumab appears to have considerable economic benefits in the management of AD over other biologics.
METHODS: Based on comparative efficacy data from Silverberg et al. (2021) and from Guyot et al (2024) on systemic AD therapies, an Excel model was developed to estimate the NNT and incremental CPR per year. The model compared dupilumab, tralokinumab, and lebrikizumab in combination with topical therapy over a 16-week treatment period. Response to treatment was defined as a 75% reduction from the baseline in Eczema Area and Severity Index (EASI-75) at Week 16. NNT was calculated as the inverse of the absolute risk reduction versus standard of care for each biologic. Current US list prices based on RED BOOK (IBM Micromedex, 2024) were used for the drugs. Sensitivity analyses were done based on the drug price variation for tralokinumab and lebrikizumab.
RESULTS: The NNT to achieve one additional responder was lower with dupilumab versus tralokinumab (3 versus 4) and lebrikizumab (3 versus 6), respectively, considering EASI-75 as the response measure. The CPR/year to achieve EASI-75 was higher for tralokinumab ($61.4K versus $45.6K) and lebrikizumab ($92.1K versus $45.6K) versus dupilumab. These results were consistent in the sensitivity analyses.
CONCLUSIONS: Dupilumab demonstrated a lower NNT and approximately 1.5- and 2-times lower CPR/year, compared to tralokinumab and lebrikizumab, respectively. Dupilumab appears to have considerable economic benefits in the management of AD over other biologics.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE264
Topic
Economic Evaluation
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin), STA: Biologics & Biosimilars