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A recent Health Technology Assessment (HTA) report by the United Kingdom’s National Institute for Health and Care Excellence (NICE) concludes that adalimumab, etanercept, and ustekinumab improve the symptoms of psoriasis in children and young people in the short term, but the cost-effectiveness of these medications requires further study.
A recent Health Technology Assessment (HTA) report by the United Kingdom’s National Institute for Health and Care Excellence (NICE) concludes that adalimumab, etanercept, and ustekinumab all improve the symptoms of psoriasis in children and young people in the short term, but because there is such a limited body of evidence on the use of these drugs in children, the effects of biologic therapies later in patients’ lives are unclear, and the cost-effectiveness of these medications requires further study.
NICE researchers, led by Ana Duarte, MD, investigated health-related quality of life (QOL) gains associated with treatment, as well as the number of hospitalizations in children and young people with plaque psoriasis who were using 1 of the 3 biologics approved for use by the United Kingdom’s National Health Service (NHS) for that indication. They found that biological treatments appear to offer some benefits, but may not be cost-effective for the management of psoriasis in children and young people at the willingness-to-pay threshold of £30,000 (approximately $39,735) per quality-adjusted life-year unless an assumption is made that the consequences of biologic treatment long-term in children are the same as those in adults.
The cost-effectiveness analysis considered 3 separate populations:
The report concluded the following:
Finally, the authors advise continued collection of data through registries of biological therapies for individuals aged under 18 years. These data will allow researchers to better understand safety, patterns of treatment switching, impact on comorbidities, and long-term withdrawal rates for these therapies. The uncertainty surrounding the effectiveness of biological treatments in children and young people could be substantially reduced through adequately powered randomized clinical trials, which are currently lacking.