OBJECTIVES: To demonstrate the cost-effectiveness of bimekizumab versus ustekinumab and adalimumab for patients with moderate-to-severe plaque psoriasis in Greece.

METHODS: A markov model with life-time horizon was locally adapted, from a public payer perspective, in which a treatment sequence starting with bimekizumab was compared to one of each comparator. Ustekinumab was chosen as a marketed IL (almost 25%), while adalimumab is the most marketed anti-TNF treatment (almost 45%), representing two well-established therapies that constitute standard practice for the treatment of moderate-to-severe plaque psoriasis in Greece, and as such were selected as comparators for the analysis. Treatment response was defined as complete resolution in Psoriasis Area and Severity Index (PASI) score (PASI 100), as suggested by clinical experts. Efficacy and safety data were obtained from network meta-analysis and utility values were elicited from published literature. Direct costs pertaining to drug acquisition, administration, monitoring, adverse events and best supportive care were considered in the analysis (€, 2022). Model outcomes were presented as incremental cost-effectiveness ratios (ICER) per quality-adjusted life-year (QALY) gained. Sensitivity analyses were used to explore the impact in changing input data.

RESULTS: Compared to ustekinumab and adalimumab, bimekizumab was the most effective (1.29 and 1.30 incremental QALY gains, respectively) and most costly (€69,222 and €69,605 incremental costs per year) strategy generating an ICER of €53,624 and€53,700 per QALY gained, respectively. One-way sensitivity and scenario analyses confirmed the cost-effectiveness of bimekizumab. Moreover, findings of sensitivity analysis confirmed the robustness of the deterministic base case results, amplifying the conclusion that bimekizumab was a more expensive but more effective treatment option compared to ustekinumab and adalimumab.

CONCLUSIONS: In this economic evaluation bimekizumab seems to have successfully expanded the therapeutic armamentarium for the management of moderate-to-severe plaque psoriasis offering a therapeutic option that is not only clinically effective but also economically efficient.