Cost-effectiveness analysis of secukinumab versus standard of care in the treatment of psoriatic arthritis: A Vietnam National health insurance perspective

Abstract

Psoriatic arthritis (PsA) is a chronic, systemic inflammatory disease. This study assessed the cost-effectiveness of secukinumab, an interleukin-17A inhibitor, versus standard of care (SoC) from Vietnam’s National Health Insurance (NHI) perspective. Model-based cost-effectiveness analysis, the structure was a 3-month decision tree leading into a Markov model. Clinical parameters, including responses at 3 months, were from the FUTURE 2 trial. Cost parameters were from real data at the National Hospital of Dermatology and Venereology and a research period. The outcome included total costs and quality-adjusted life years (QALYs) over a life-time horizon (3.5% annual discount for both outcomes and cost), and incremental cost-effectiveness ratios (ICER). The robustness of the study findings was evaluated via sensitivity analysis. Patients treated with secukinumab achieved with QALY gain 1.16 versus SoC, but associated with higher total costs was 211.3 million VND over lifetime horizon. ICER for secukinumab vs SoC was 181.6 million VND lower than a willingness to pay threshold recommended in Vietnam (3GDP per capita equal to 286.8 million VND). Deterministic sensitivity analysis indicated that parameters related to Health Assessment Questionnaire scores were most influential. At the willingness to pay threshold of three times the GDPpc, the probability of secukinumab being cost-effective was 90.3% in the probabilistic sensitivity analysis. Secukinumab is a cost-effectiveness treatment versus SoC for PsA patients from the National health insurance’s perspective of Vietnam.