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 the United Kingdom (UK).
METHODS: Work Productivity and Activity Impairment (WPAI) data from employed patients in CLEAR, a head–to-head study comparing secukinumab and ustekinumab, were used to assess the impact of psoriasis on work, and were applied to FIXTURE, a study comparing secukinumab and etanercept. Efficacy at 16 and 52 weeks was measured by Psoriasis Area and Severity Index (PASI) improvements from baseline: less than 50% (PASI < 50), 50%-74% (PASI 50-74), 75%-89% (PASI 75-89), and at least 90% (PASI ≥ 90). Work impairment by PASI response was used to estimate weekly and annual mean work hours lost due to psoriasis. PASI response distributions were assumed consistent across employed and non-employed patients in both studies. Average hours lost across both groups were calculated for all treatments. Annual indirect costs were based on UK Office for National Statistics average earnings data.
RESULTS: In CLEAR, 502 patients (67%) were employed at baseline. At week 52, percentages of weekly work impairment/mean hours lost decreased with higher PASI: PASI < 50: 26.3%/8.77 hours; PASI 50-74: 16.4%/5.46 hours; PASI 75-89: 10.4%/3.46 hours; and PASI ≥ 90: 6.9%/2.30 hours. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than for ustekinumab (1.93/100.69 vs. 2.35/122.72; Ρ = 0.0001). Consistent results were obtained for secukinumab versus etanercept (2.44/127.15 versus 3.27/170.48; Ρ = 0.0001). Average annual indirect cost-savings with secukinumab were £346.26 versus ustekinumab and £681.13 versus etanercept. Results at 16 weeks were similar (Ρ = 0.0001).
CONCLUSIONS: Secukinumab significantly reduces work impairment and associated indirect costs of psoriasis, when compared with ustekinumab and etanercept, as early as week 16 and up to week 52.
