OBJECTIVES: To conduct a literature review of cost-effectiveness studies comparing subcutaneous secukinumab to other biologics in the management of psoriatic arthritis (PsA).

METHODS: A literature search was conducted in PubMed up until December 2020. The key search terms included psoriatic arthritis, cost-effectiveness analysis, and secukinumab. The inclusion criteria were subcutaneous secukinumab 150 mg or 300 mg, biologic-naïve or experienced adults (≥18 years old), active PsA, and outcomes reported after at least 12-weeks follow-up. Data on decision model, perspective, comparators, time horizon, costs, outcomes, price year, sensitivity analysis, and results were extracted from the reviewed studies.

RESULTS: Out of 29 studies identified, seven cost-effectiveness studies met the inclusion criteria and were included in the review. Studies conducted in Argentina, Canada, Finland, and Germany in biologic-naïve patients against comparators such as adalimumab, certolizumab pegol, entanercept, golimumab, ustekinumab, and apremilast showed that secukinumab 150 mg produced more QALYs at a lower cost. When compared to infliximab, secukinumab produced marginally less QALYs but was more cost-effective with an ICER ranging from $816,417.82/QALY to $20,784,684/QALY. Studies from Argentina, Canada, and Finland showed that secukinumab 300 mg in biologic-experienced patients produced greater QALYs. Interestingly, in a study from the United Kingdom, secukinumab 300 mg was more cost-effective than all biologics except for ixekizumab, which produced more QALYs at a lower cost for both biologic-naïve and experienced patients. In Spain, ixekizumab was more cost-effective than secukinumab in biologic-naïve patients. For biologic-naïve and experienced patients, total costs and QALYs for secukinumab ranged from $191,617 to $212,472 and 3.875-7.989, respectively.

CONCLUSIONS: Based on the 7 international studies, secukinumab was more cost-effective than all other subcutaneous, intravenous, and oral biologics except ixekizumab. Factors that were found to influence cost-effectiveness of secukinumab included costs associated with drug acquisition, administration, adverse events, and monitoring; and patient factors such as PsA severity.