OBJECTIVES: The severity of psoriasis can impact work productivity. Whether differential treatment efficacy translates into differential indirect cost-savings is unknown. We compared indirect costs associated with secukinumab, ustekinumab and etanercept in Tunisia.
METHODS: Work Productivity and Activity Impairment (WPAI) data from employed patients in CLEAR study (secukinumab versus ustekinumab) were used to assess the impact of psoriasis on work, and were applied to FIXTURE study (secukinumab versus etanercept). Weighted weekly and annual average indirect costs per patient per treatment were calculated from (1) overall work impairment derived from WPAI data collected in CLEAR at 16 and 52 weeks by Psoriasis Area and Severity Index (PASI) response level; (2) weekly/annual work productivity loss by PASI response level; (3) weekly and annual indirect costs by PASI response level, based on hours of work productivity loss; and (4) weighted average indirect costs for each treatment. Employment data was based on Tunisian Annual Statistics, 2013 data.
RESULTS: In CLEAR, 452 patients (67%) were employed at baseline. At week 16, percentages of overall work impairment/weekly mean hours lost decreased with higher PASI response: PASI < 50: 22.8%/10.76 hours; PASI 50-74: 13.3%/6.30 hours; PASI 75-89: 6.4%/3.03 hours; and PASI ≥ 90: 4.9%/2.33 hours. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than ustekinumab (2.78/145.15 versus 3.40/177.16; Ρ = 0.0006). Similar results were obtained for secukinumab versus etanercept (3.25/169.45 versus 5.08/265.02; Ρ < 0.0001). Average annual indirect cost-savings with secukinumab were 108.94 TND versus ustekinumab (Ρ = 0.0006) and 325.26 TND versus etanercept (Ρ < 0.0001). Secondary analyses using week 52 data, different PASI distributions, or considering the full employed and non-employed patient population, supported these results.
CONCLUSIONS: Secukinumab significantly reduces work impairment and associated indirect costs of psoriasis, when compared with ustekinumab and etanercept, at week 16 through week 52.
