• Atsuyuki Igarashi, Hiroyo Kuwabara, Kyle Fahrbach, and Brad Schenkel.
• Department of Dermatology, NTT Medical Center Tokyo, Tokyo, Japan. igarashi@east.ntt.co.jp
• J Dermatolog Treat. 2013 Oct 1; 24 (5): 351-5.

BackgroundBiological therapies have recently been introduced for patients with moderate to severe psoriasis in Japan.ObjectivesThis research aims to assess the cost efficacy of adalimumab, infliximab and ustekinumab treatments for psoriasis in a Japanese environment.MethodsA mixed-treatment comparison was performed to estimate the comparative efficacy of biological therapies using Psoriasis Area and Severity Index (PASI) scores based on data from randomized, double-blind, controlled studies. Costs included only the drug costs calculated by the approved dosing and schedule. Cost efficacy was determined by dividing the cost by the probability of achieving a PASI 75 response.ResultsInfliximab had the highest probability of a PASI 75 response (83%), followed by ustekinumab 45 mg (74%) and adalimumab (59%). Infliximab was the most expensive biologic, whereas the costs of ustekinumab 45 mg and adalimumab were similar. In the first year of induction treatment, the lowest cost per responder was for ustekinumab 45 mg, followed by adalimumab and infliximab. In the subsequent year of maintenance treatment, the cost per responder of ustekinumab 45 mg remained the lowest while infliximab and adalimumab had similar cost efficacy.ConclusionsUstekinumab was a more cost-efficient biological therapy than adalimumab or infliximab for psoriasis patients in a Japanese setting.

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