Cost-per-Responder Analysis of Bimekizumab (IL-17A/F Inhibitor) Against IL-Inhibitors for Psoriatic Arthritis in...

Bimekizumab is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F and IL-17A and was approved to treat patients with active psoriatic arthritis (PsA) in the European Union in 2023. This study compares the cost per responder (CPR) of bimekizumab against IL-17A (secukinumab), IL-12/23 (ustekinumab) and IL-23 (guselkumab and risankizumab) targeted therapies to treat patients with PsA in Spain.

The CPR was calculated by dividing the average annual drug cost per patient by the response rates for minimal disease activity (MDA) and American College of Rheumatology (ACR) 50 and ACR70 at week 52 in patients who were biological disease-modifying antirheumatic drug (bDMARD) naïve or who had experienced inadequate response or intolerance to tumour necrosis factor inhibitors (TNFi-IR). Response rates from four published matching-adjusted indirect comparisons (MAIC) were used. Spanish list prices and Royal Decree Law 8/2010 discounts were considered.

In bDMARD-naïve patients, bimekizumab had a lower CPR for MDA and ACR70 versus all comparators except for secukinumab 150 mg, where the CPR for bimekizumab was higher for all three efficacy measures. The incremental CPR ranged between 17.2% (95% confidence interval [CI] - 26.1%, 50.6%) for ACR70 and 92.7% (95% CI 60.0%, 119.4%) for ACR50. The incremental CPR for ACR50 for bimekizumab compared to secukinumab 300 mg was also slightly higher (2.3% [95% CI - 12.5%, 14.3%]). In patients with TNFi-IR, bimekizumab was more cost-efficient than all comparators for the three response rate measures at week 52.

CPR analyses based on MAIC response rates at week 52 suggest that bimekizumab is more cost-efficient than IL-12/23 and IL-23 therapies, including ustekinumab, guselkumab and risankizumab, for treating PsA in Spain across both bDMARD-naïve patients and patients with TNFi-IR for all outcomes (MDA, ACR50/70). Compared to IL-17A (secukinumab), bimekizumab is consistently cost-efficient in patients with TNFi-IR for all outcomes and is cost-efficient in bDMARD-naïve patients versus those taking 300 mg regarding MDA and ACR70.