T-44: A Real World Budget Impact Analysis of Apremilast or Biologic Treatment in Biologic-Naive Patients With Psoriasis

Poster Presenter

Brian Ung

Manager, U.S. Health Economics & Outcomes Research (HEOR)
Celgene Corporate
United States

Objectives

This study assessed the pharmacy and outpatient medical budget impact to a US third-party payer when increasing apremilast use for biologic-naive patients with psoriasis by utilizing real-world evidence as a primary data source.

Method

A budget impact model was used to estimate 2-year apremilast or biologic therapy pharmacy and outpatient medical costs. Data from 2 claims analyses were used as inputs for first- and second-line market share, costs, and rates of treatment switching. Two-way sensitivity analysis was also completed.

Results

A base case scenario of 5 million US plan members compared 2548 moderate/severe psoriasis patients pre- vs. post-apremilast use. Increasing apremilast market share in first-line use by 3% in this scenario, from 16% to 19%, resulted in total cost savings of $2,644,600 to $3,213,645, depending on the database analysis utilized in the model. The per-patient per-month reductions ranged from $43.25 to $52.56 and per-member per-month reductions ranged from $0.02 to $0.03. Key drivers for the total cost savings were apremilast first-line market share and biologic pharmacy costs in the first and second lines of treatment. An additional 1% increase in apremilast first-line market share (e.g., 20%) increased the total cost savings by approximately 33%.

Conclusion

Based on real-world data, increasing access to and use of apremilast may be a cost-saving strategy in biologic-naive patients with moderate to severe psoriasis. Results of the budget impact model are limited to the data sources utilized at the time of development. Actual cost savings may differ depending on current drug prices, market share, and rates of treatment switching.