Economic evaluation of adalimumab versus etanercept for psoriatic arthritis in a Brazilian real-world model

• Published in: Expert review of pharmacoeconomics & outcomes research Vol. 22; no. 3; p. 473
• Main Authors: da Silva, Michael Ruberson Ribeiro, Dos Santos, Jéssica Barreto Ribeiro, Almeida, Alessandra Maciel, Alvares-Teodoro, Juliana, Acurcio, Francisco De Assis
• Format: Journal Article
• Language: English
• Published: England 03.04.2022
• Subjects: Adalimumab - therapeutic use; Antibodies, Monoclonal; Antirheumatic Agents - therapeutic use; Arthritis, Psoriatic - drug therapy; Brazil; Cost-Benefit Analysis; Etanercept - therapeutic use; Humans; Quality-Adjusted Life Years; Brazil; cost-utility analysis; psoriatic arthritis; Adalimumab; etanercept
• ISSN: 1744-8379
• DOI: 10.1080/14737167.2021.1880325

TNF inhibitors are costly drugs supplied generally on health systems or private insurances. Performance analysis is essential to verify the results achieved by health technologies in these systems. The objective of the study was to compare the two most used biological drugs for the treatment of psoriatic arthritis (PsA) in Brazil. A cost-utility analysis was built using a Markov model, with a five-year time horizon, a discount rate of 5%, and from the perspective of the Unified Health System. Deterministic and probabilistic sensitivity analyses were performed. Etanercept was the most cost-effective drug. Adalimumab became the most cost-effective drug in one of the four analysis scenarios with a willingness to pay from one gross domestic product per capita. The deterministic sensitivity analysis identified that the cost parameters had the greatest impact on the most effective drug. The probabilistic sensitivity analysis indicated that etanercept is the drug most likely to be cost-effective. The difference between the drugs in terms of utility was minimal and the costs were the main factor that impacted the cost-utility ratio, which points to the benefits of price renegotiation for the efficient allocation of resources in the health system.