Cost‐effectiveness analysis of abrocitinib compared with standard of care in adult moderate‐to‐severe atopic dermatitis in Japan

Abstract

AbstractAtopic dermatitis (AD) is a chronic inflammatory skin disease with a significant clinical, economic, and human burden. The JAK1 Atopic Dermatitis Efficacy and Safety (JADE) program's Phase 3 trials demonstrated that as a treatment for moderate‐to‐severe AD in adults with previous exposure to immunotherapy, abrocitinib showed superior efficacy and safety compared with standard of care (SoC), consisting of topical corticosteroids. This study assessed the cost‐effectiveness of abrocitinib with SoC versus SoC alone for this patient population in Japan from a societal perspective. A hybrid decision tree and Markov model were used to capture the initial treatment and long‐term maintenance phases. Clinical inputs at 16 weeks were obtained through a Bayesian network meta‐analysis of four pivotal trials from the JADE program. Clinical inputs at 52 weeks were derived from the JADE EXTEND trial. Response‐specific utility inputs were obtained from published literature. Resource use, costs, and productivity inputs were gathered from Japanese claims analysis, literature, public documents, and expert opinion. Costs and quality‐adjusted life years (QALYs) were discounted at 2.0% per year and incremental cost‐effectiveness ratios (ICERs) were calculated. Sensitivity and scenario analyses were performed to validate the base case results and explore a payer perspective. Over a lifetime horizon and with the base‐case societal perspective, abrocitinib produced a mean gain of 0.75 QALYs, incremental costs of JPY (¥) 2 270 386 (USD [$] 17 265.6), and a resulting ICER of ¥3 034 514 ($23 076.5) per QALY compared with SoC. From a payer perspective, the incremental costs increased to ¥4 476 777 ($34 044.4), with an ICER of ¥5 983 495 ($45 502.6) per QALY. The results were most sensitive to treatment‐specific, response‐based utility weights, drug costs, and productivity‐related inputs. From a Japanese societal perspective, abrocitinib demonstrated superior QALYs and with a willingness‐to‐pay threshold of ¥5 000 000 ($38 023.4) per QALY, can be considered cost‐effective compared with SoC as a treatment for moderate‐to‐severe AD in adult patients with previous immunosuppressant exposure.