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Apremilast (Otezla) [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Sep.
| Drug/Comparator | Strength | Dosage Form | Price ($) | Recommended Dose | Average Annual Cost ($) |
|---|---|---|---|---|---|
| Apremilast (Otezla)a | 10 mg 20 mg 30 mg | Tablet | ▬a | 30 mg twice daily | First year: ▬b Subsequent years:▬ |
| Biologies | |||||
| Adalimumab (Humira) | 40 mg/0.8 mL | Syringe or pen | $740.3600 | 80 mg first dose, 40 mg every other week starting one week after first dose | First year: $20,730 Year 2 onwards: $19,249 |
| Etanercept (Enbrel) | 50 mg/mL 25 mg/vial | Syringe or pen Vial | $395.3900 $197.6350 | 50 mg twice weekly for 12 weeks, then 25 mg twice weekly | First year: $25,300c Year 2 onwards: $20,554 |
| Infliximab (Remicade) | 100 mg/vial | Vial | $962.6800d | 5 mg/kg/dose, for 3 doses (0, 2, 6 weeks) then 5 mg/kg every 8 weeks | First year: $38,507e Year 2 onwards: $31,287 |
| Infliximab (Inflectra) | $525.0000 | First year: $21,000 Year 2 onwards: $17,063 | |||
| Secukinumab (Cosentyx) | 150 mg/mL | Pre-filled syringe | $1,645.0000 per 300 mg dosef (2 x 150 mg syringes/pkg) | 300 mg SC injection at weeks 0, 1, 2, and 3, then monthly starting week 4 | First year: $26,320 Year 2 onwards: $19,740 |
| Ustekinumab (Stelara) | 45 mg/0.5 mL 90 mg/1 mL | Pre-filled syringe | $4,593.1400 |
| First year: $22,966 Year 2 onwards: $20,669g |
| Systemic treatments | |||||
| Methotrexate | 2.5 mg 10 mg 10 mg/mL 25 mg/mL | Tab Tab Vial/inj Vial/inj | $0.6325 $2.7000h $12.5000/2 mL $8.9200/2 mL | 10 mg to 25 mg by mouth or IM weekly | $132 to $329 $232 to $325 |
| Cyclosporine (Neoral) | 10 mg 25 mg 50 mg 100 mg | Capsule | $0.6238 $0.9952 $1.9400 $3.8815 | 2.5 mg/kg daily (rounded to 200 mg/day) (max 5 mg/kg/day) | $2,833i |
| Acitretin (Soriatane) | 10 mg 25 mg | Capsule | $2.3573 $4.1400 | 25 mgto 50 mg daily | $1,507 to $3,014 |
IM = intramuscular; inj = injection; max = maximum; pkg = package; pt = patient; SC = subcutaneous.
Manufacturer’s submitted confidential price. Notes: the 10 mgand 20 mg dose tablets are available only in a starter pack; manufacturer’s submitted price is ▬| more expensive than the currently listed price per tablet under the Regie de I’Assurance Maladie du Quebec formulary.24
First year includes tit rat ion period with equivalent ly priced 10 mg and 20 mg pills.
First-year cost includes use of 50 mg syringe for the first 12 weeks, followed by use of 25 mg vials. In subsequent years, patients are assumed to use 25 mg vials exclusively; costs are $20,560 if 50 mg syringes are used.
Source: Alberta formulary (April 2016).25
Assumes wastage of partially used vials occurs. Eight treatments first year, 6.5 average subsequent years. Note: Average weight was assumed to be 88.67 kg, as per manufacturer’s trials and values used in models.
Source: IMS Brogan DeltaPA.26
Five treatments first year, 4.5 average subsequent. Price for 45 mg and 90 mg is the same.
Source: Saskatchewan formulary (April 2016).27
Lower value assumes 200 mg/day; upper end assumes dosage for average body weight from PSOR-010 (LIBERATE) trial.
Source: Ontario Drug Benefit (April 2016)14, except where noted.
From: APPENDIX 1, Cost Comparison
Except where otherwise noted, this work is distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International licence (CC BY-NC-ND), a copy of which is available at http://creativecommons.org/licenses/by-nc-nd/4.0/
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