OBJECTIVES

: Psoriasis affects approximately 125 million people worldwide with a prevalence rate of 2-3%. In the Kingdom of Saudi Arabia (KSA), psoriasis accounts for 5.3% of all newly diagnosed cases of skin diseases. It significantly reduces health-related quality-of-life and work productivity. The management of psoriasis mainly include topical treatments, conventional systemic treatments, and biologics. Due to the significant cost associated with the usage of advanced biologics (such as ixekizumab, guselkumab, risankizumab and secukinumab), these are not yet included in the Ministry of Health (MoH) formulary of KSA. This study assessed the budgetary impact of introducing ixekizumab, guselkumab, risankizumab and/or secukinumab in the MoH formulary of KSA for the management of moderate-to-severe psoriasis.

METHODS

: A budget impact model was developed which assessed four different scenarios- (1) introduction of risankizumab first-line with secukinumab second-line; (2) guselkumab first-line with secukinumab second-line; (3) risankizumab first-line with ixekizumab second-line; and (4) guselkumab first-line with ixekizumab second-line over a five-year time horizon. The key model inputs included the estimated number of moderate-to-severe psoriasis patients eligible for treatment with biologics in MOH facilities, treatment response rates, market shares, adverse event rates and costs, treatment costs, and monitoring cost. Inputs were retrieved from literature and validated by experts through face-to-face interviews.

RESULTS : The study showed a minimal increase in the overall budget with all scenarios compared to the status-quo: an increase of Saudi Arabia Riyal (SAR) 1.3 million (0.4%) in scenario 1, SAR 1.5 million (0.5%) in scenario 2, SAR 2.1 million (0.7%) in scenario 3 and SAR 2.4 million (0.8%) in scenario 4 over five-year time horizon.

CONCLUSIONS : The introduction of advanced biologics in the KSA MoH formulary for the management of moderate-to-severe psoriasis patients could minimally increase the MoH budget.