Report Evaluates Cost-Effectiveness of Targeted Therapies for Plaque Psoriasis


Guselkumab and risankizumab were found to be superior to non-targeted therapies for the treatment of moderate-to-severe plaque psoriasis.

In its latest report, the Institute for Clinical and Economic Review (ICER) evaluated the efficacy and value of newer targeted agents that treat moderate-to-severe plaque psoriasis compared with non-targeted therapies.

Most notably, treatments guselkumab (Tremfya, Johnson & Johnson) and risankizumab (AbbVie) succeeded in demonstrating greater clinical benefit when compared with non-targeted therapies, according to ICER.

At a public meeting, the ICER received input from members of the New England Comparative Effectiveness Public Advisory Council, one of ICER’s 3 independent evidence appraisal committees, based on newly incorporated clinical data and cost information. The updated report, which adds to the 2016 findings, includes recently-approved drugs and risankizumab, which was filed with the FDA for review in April 2018.

Council members further voted that evidence was not adequate to show a net health benefit of tildrakizumab (Ilumya, Sun Pharma/Merck) compared with TNFα inhibitors or the TNFα inhibitor certolizumab pegol over the other subcutaneously-administered TNFα inhibitors (adalimumab and etanercept).

Additionally, council members indicated that these new therapies seemed to reduce complexity of care, reduce caregiver or family burden, improve ability to return to work or other activities, and use a novel mechanism of action.

“Similar to the findings of our 2016 report, we again found that many targeted therapies offer benefit over non-targeted therapies, and we are able to further clarify which agents may be most effective,” Dan Ollendorf, PhD, ICER’s chief scientific officer said in a press release.

Of the therapies reviewed, council members concluded that guselkumab exhibited better long-term value for money compared with non-targeted therapies. On the other hand, certolizumab pegol was found to offer a low long-term value due to its high price tag and lack of superiority in its therapeutic class. However, council members noted it as an important option for women who are pregnant or breastfeeding due to evidence regarding its safe use in those individuals.

“While many of these therapies currently represent reasonable value, patients continue to face insurance barriers that interfere with their access to these potentially life changing therapies, and recent prices increases for many agents may further limit access,” Ollendorf said in the press release.

In ICER’s updated policy recommendations, the institute calls for insurers to minimize step therapy requirements on these treatments that are priced in alignment with clinical benefits. The recommendations also urge transparency from manufacturers in the rationale for price increases on these drugs.


Institute for Clinical and Economic Review Updated Report on Targeted Treatments for Plaque Psoriasis Finds Guselkumab and Risankizumab Offer Superior Health Benefit Compared with TNFα Inhibitors [news release]. ICER’s website. Accessed August 6, 2018.

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