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Cost-Effectiveness Analysis of Ritlecitinib Compared With No Treatment in Patients With Severe Alopecia Areata in

Akira Yuasa1, Kazumasa Kamei1, Shota Saito2

  • 1Japan Access and Value, Pfizer Japan Inc., Tokyo, Japan.

The Journal of Dermatology
|March 10, 2026
PubMed

Insights

Ritlecitinib is a cost-effective treatment for severe alopecia areata (AA) in Japan, offering improved quality of life. This JAK inhibitor provides significant benefits compared to no treatment for patients with substantial scalp hair loss.

Area of Science:

  • Pharmacoeconomics
  • Dermatology
  • Clinical Trials

Background:

  • Alopecia areata (AA) significantly impacts quality of life and productivity.
  • Ritlecitinib, a dual JAK3/TEC kinase inhibitor, has shown efficacy in treating severe AA.
  • Cost-effectiveness data for ritlecitinib in Japan were previously unavailable.

Purpose of the Study:

  • To evaluate the cost-effectiveness of ritlecitinib compared to no treatment for severe AA in Japan.
  • To estimate the lifetime costs and quality-adjusted life years (QALYs) associated with ritlecitinib treatment.
  • To assess the societal perspective on the economic value of ritlecitinib for AA patients.

Main Methods:

  • A Markov model was utilized, stratifying patients by Severity of Alopecia Tool (SALT) scores.
  • Clinical data were derived from the ALLEGRO phase 2b/3 trial.
  • Lifetime costs, including productivity losses, and QALYs were calculated and discounted at 2% annually.

Main Results:

  • Ritlecitinib 50 mg yielded an incremental QALY of 1.09 and incremental costs of 5,262,471 JPY.
  • The incremental cost-effectiveness ratio (ICER) was 4,816,589 JPY per QALY, below Japan's threshold.
  • Sensitivity analyses identified patient utility, presenteeism, and discontinuation rates as key factors influencing the ICER.

Conclusions:

  • Ritlecitinib 50 mg is a cost-effective treatment option for patients with severe AA (≥50% scalp hair loss) in Japan from a societal perspective.
  • The findings support the economic viability of ritlecitinib in managing severe alopecia areata.
  • Further research may explore long-term adherence and real-world economic impacts.
Keywords:
Japanalopecia areatacost‐effectiveness analysisemployer health costsritlecitinib

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