Objectives: To demonstrate the cost-effectiveness of bimekizumab, a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F in addition to IL-17A, against biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) for patients with active psoriatic arthritis (PsA) in Greece.

Methods: A previously peer-reviewed and published Markov model with a lifetime horizon was locally adapted and utilized, evaluating treatment response based on American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index (PASI) changes. According to local clinical experts, 64% of total PsA patients have prior exposure to one or more tumor necrosis factor-alpha inhibitors (TNFi); thus, TNFi-experienced patients were chosen for analysis, based on BE COMPLETE phase 3 trial population of bimekizumab. Efficacy and safety data were obtained from bimekizumab clinical trials and a published network meta-analysis. Direct costs were considered (€, 2023). As only TNFi-experienced patients were included in the analysis, secukinumab 300mg was used to reflect its licensed posology. Additionally, scenario analyses were conducted comparing bimekizumab with the latest recently available b/tsDMARDs in the PsA market (ixekizumab and risankizumab) and two available Janus kinase inhibitors (tofacitinib and upadacitinib) for managing adult Greek PsA patients. Model outcomes were presented as incremental cost-effectiveness ratios (ICERs), considering differences in per quality-adjusted life-years (QALY) gained and associated costs. Extensive sensitivity analyses were performed to explore input data variations.

Results: Bimekizumab was more effective (+0.54 QALYs) and more expensive (+€14,117) than secukinumab 300mg, with an ICER of €26,264 per QALY gained, below the willingness- to- pay threshold in Greece (€51,000). All sensitivity analyses confirmed these cost-effectiveness estimates. Scenario analyses suggested that bimekizumab was cost-effective compared to ixekizumab (€23,488), risankizumab (€24,705), tofacitinib (€27,310), and upadacitinib (€32,122).

Conclusions: The analysis suggests that the additional therapeutic benefits of bimekizumab makes it a cost-efficient treatment option, in Greece, despite its incrementally higher costs.