Cost-effectiveness of deucravacitinib versus apremilast of moderate-to-severe plaque psoriasis in China.

Objectives: The study aimed to assess the cost-effectiveness of deucravacitinib versus apremilast for treating moderate-to-severe plaque psoriasis from the Chinese healthcare system's perspective.

Methods: The treatment efficacy of deucravacitinib was compared with apremilast using response rates derived from the head-to-head phase 3 clinical trials, POETYK PSO-1 and PSO-2. A decision-tree (first 24-week)/ Markov model (later period) was constructed to estimate the incremental cost per quality-adjusted life-year (QALY) gained over a lifetime horizon. The efficacy inputs were based on randomized controlled trials, while adverse event rates, discontinuation probabilities, costs, and utility data were obtained from relevant literature and Chinese sources. A 5% annual discount rate was used for the analysis of outcomes and costs. Model outcomes were characterized by quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER). One-way sensitivity analysis and probability sensitivity analysis (PSA) were performed to examine the robustness of the results.

Results: According to the assumed lifetime horizon and model, the ICER of deucravacitinib 6 mg once daily compared with apremilast 30 mg twice daily was 140,047 CNY per QALY. Deucravacitinib was more cost-effective than apremilast at the willingness-to-pay (WTP) threshold of 287,247 CNY per QALY. In the One-way sensitivity analysis, the cost of deucravacitinib was identified as the parameter exerting the greatest impact on the base-case results. The results of PSA showed the probability of deucravacitinib being cost-effective was 99.4%.

Conclusion: At the WTP threshold of 287,247 CNY, deucravacitinib 6 mg once daily was a cost-effective treatment strategy for moderate-to-severe plaque psoriasis compared with apremilast 30 mg twice daily from the Chinese healthcare system perspective over a lifetime horizon.