A Cross-Indication Budget Impact Model of Secukinumab for the Treatment of Psoriasis, Psoriatic Arthritis, Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis in Italy

Paolo Angelo Cortesi, Carla Fornari (), Paolo Gisondi, Florenzo Iannone, Ippazio Cosimo Antonazzo, Elisabetta Aloisi, Martina Fiocchi, Daniela Ritrovato and Lorenzo Giovanni Mantovani
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Paolo Angelo Cortesi: University of Milan-Bicocca
Carla Fornari: University of Milan-Bicocca
Paolo Gisondi: University of Verona
Florenzo Iannone: University of Bari, Policlinico
Ippazio Cosimo Antonazzo: University of Milan-Bicocca
Elisabetta Aloisi: Novartis Farma SpA
Martina Fiocchi: Novartis Farma SpA
Daniela Ritrovato: Novartis Farma SpA
Lorenzo Giovanni Mantovani: University of Milan-Bicocca

PharmacoEconomics - Open, 2023, vol. 7, issue 3, No 7, 405-416

Abstract: Abstract Background Recent developments improved outcomes in patients with autoimmune diseases. Biologics were approved as first-line treatment in selected naïve patients with plaque psoriasis (PsO), psoriatic arthritis (PsA), ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). Among them, secukinumab was most recently approved for treatment of active nr-axSpA in adults. In this work, we assessed the budget impact of new secukinumab treatment options in the Italian market. Methods A cross-indication budget impact model was designed to estimate the effects of adding secukinumab in the Italian market from the National Health System perspective over a 3-year period. The model included all adults with PsO, PsA, AS and nr-axSpA, treated with biologics or biosimilars. It compared costs between two scenarios, secukinumab availability or absence, for the four diseases combined and taken individually. A sensitivity analyses was conducted. Results There were 68,121 adult patients treated with biologics in 2021 and 68,341 in 2023. The budget impact analysis (BIA) on all indications showed a cost reduction of €33.7 million (− 1.5%) over 3 years with the introduction of secukinumab. PsA patients had the highest saving (− €34.9 million), followed by PsO patients (− €7.8 million). Cost saving in PsO patients was balanced by increased budget reported in AS patients (+ €8.0 million). In nr-axSpA patients, secukinumab reported no significant budget increase (+ 1.0%). Conclusion This BIA accounted for the new indication of secukinumab in nr-axSpA patients, reporting no significant changes in the required budget and adding an effective treatment option. Considering all indications, secukinumab is a sustainable treatment option.

Date: 2023
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DOI: 10.1007/s41669-023-00404-3

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