Secukinumab Vs Adalimumab for the Treatment of Ankylosing Spondilytis: A Cost Per Responder Analysis at 52 Weeks from a Moroccan Perspective

OBJECTIVES: The objective of this analysis was to estimate and compare the long-term cost per responder (CPR) based on the Assessment of Spondyloarthritis International Society (ASAS) outcomes following 52 weeks of treatment with secukinumab 150mg (SEC,anti-IL-17A) relative to adalimumab (ADA, anti-TN) for ankylosing spondylitis (AS). METHODS: The CPR for each treatment was estimated by dividing the drug acquisition cost by its response rate. Drug costs were estimated on the basis of the official Agence nationale de l'Assurance Maladie website (currency in MAD) and the number of doses required for 52 weeks. Long-term response rates were derived from a previous matching-adjusted indirect comparison (MAIC) based on the data from MEASURE 2 and ATLAS clinical trial. The MAIC matched patient populations on key baseline characteristics. RESULTS: The MAIC results show higher ASAS (20, 40 and 5/6) response rates for SEC compared to ADA at 52 weeks. ASAS 20, ASAS 40 and ASAS 5/6 response rates were 81% vs 65%, 62% vs 47%, 72% vs 55% for SEC vs ADA, respectively. The cost per ASAS 20 responder was MAD 117,102.00 vs MAD 227,177.00, cost per ASAS 40 responder was MAD 152,232.00 vs MAD 315,856.00 whereas, cost per ASAS 5/6 responder was MAD 131,089.00 vs MAD 270,258.00 for SEC vs ADA, respectively. The costs per ASAS (20, 40 and 5/6) responders were about 48%, 52% and 51% lower for SEC compared to ADA respectively at 52 weeks. CONCLUSIONS: The ASAS (20,40 and 5/6) response rates were higher for SEC compared to ADA at 52 weeks. The long term cost per responder for ASAS outcomes at 52 weeks were consistently lower for SEC vs. ADA. With higher outcomes at lower costs, these findings suggest dominance of SEC over ADA. AS patients could be treated more efficiently with SEC versus ADA in Morocco.