Table 4, Cost Comparison Table for the Treatment of Plaque Psoriasis - Pharmacoeconomic Review Report: Risankizumab (Skyrizi)

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Pharmacoeconomic Review Report: Risankizumab (Skyrizi): (AbbVie): Indication: For the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Jun.

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Pharmacoeconomic Review Report: Risankizumab (Skyrizi): (AbbVie): Indication: For the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy [Internet].

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Table 4Cost Comparison Table for the Treatment of Plaque Psoriasis

Drug/Comparator	Strength	Dosage Form	Price ($)	Recommended Dose	Average Annual Drug Cost ($)
Risankizumab	75 mg/0.83 mL	Pre-filled syringe	2,467.50^a	150 mg at week 0 and 4, followed by 150 mg every 12 weeks thereafter	First year: 24,675 Subsequent years: 21,385
Other Biologics
Adalimumab (Humira)	40 mg/0.8 mL	Syringe or pen	769.9700	80 mg initial dose, 40 mg every other week starting 1 week after initial dose	First year: 21,559 Subsequent years: 20,019
Brodalumab (Siliq)	210 mg/1.5 mL	Pre-filled syringe	645.0000^b	210 mg SC at weeks 0, 1, and 2, followed by every 2 weeks thereafter	First year: 17,415 Subsequent years: 16,770
Etanercept (Enbrel)	50 mg/mL 25 mg/vial	Syringe or pen vial	405.9850 202.9300	50 mg twice weekly for 12 weeks, then 50 mg weekly	First year: 25,983 Subsequent years: 21,111
Etanercept (Erelzi and/or Brenzys, SEB)	50 mg/mL 25 mg/vial	Syringe or pen vial	127.5000 255.0000	50 mg twice weekly for 12 weeks, then 50 mg weekly	First year: 16,320 Subsequent years: 13,260
Guselkumab (Tremfya)	100 mg/mL	Pre-filled syringe	3,059.7400^c	100 mg SC at weeks 0 and 4, followed by every 8 weeks thereafter	First year: 21,418 Subsequent years: 19,888
Infliximab (Remicade)	100 mg/vial	Vial	977.0000^d	5 mg/kg/dose, for 3 doses (0, 2, 6 weeks) then 5 mg/kg every 8 weeks	First year: 39,080^e Subsequent years: 31,753^e
Infliximab (Renflexis, SEB)	100 mg/vial	Vial	493.000		First year: 19,720^e Subsequent years: 16,023^e
Ixekizumab (Taltz)	80 mg/1 mL	Pre-filled syringe	1,577.2600	160 mg initial dose, 80 mg at 2, 4, 6, 8, 10, and 12 weeks followed by 80 mg every 4 weeks	First year: 26,813 Subsequent years: 20,504
Secukinumab (Cosentyx)	150 mg/mL	Pre-filled syringe or pen	822.5000	300 mg SC injection at weeks 0, 1, 2, and 3, then monthly injections starting at week 4	First year: 24,675 Subsequent years: 19,740
Ustekinumab (Stelara)	45 mg/0.5 mL 90 mg/1 mL	Pre-filled syringe	4,593.1400	< 100 kg patients: 45 mg at weeks 0 and 4, followed by 45 mg every 12 weeks thereafter (> 100 kg patients: 90 mg at same frequency)	First year: 22,966 Subsequent years: 19,904
Conventional Systemic Treatments
Methotrexate	2.5 mg 10 mg 20 mg/2 mL 50 mg/2 mL	Tablet Tablet Vial Vial	0.6325 2.7000^d 12.5000 8.9200	10 mg to 25 mg by mouth or IM weekly	140 to 325 232 to 812
Cyclosporine (generics)	10 mg 25 mg 50 mg 100 mg	Capsule	0.6238 0.9952 1.9400 3.8815	2.5 mg to 5 mg/kg daily, in 2 divided doses	3,269 to 7,084^e
Acitretin (generics)	10 mg 25 mg	Capsule	1.2965 2.2770	25 mg to 50 mg daily	831 to 1,662
Phosphodiesterase Type 4 Inhibitor
Apremilast (Otezla)	30 mg	Tablet	19.8650^c^,^f	30 mg twice daily	14,501

: IM = intramuscular; SC = subcutaneous; SEB = subsequent entry biologic.
: Note: Unless otherwise indicated, all prices are from the Ontario Drug Benefit Formulary¹⁷ (accessed November 2018) and do not include dispensing fees.
a: Manufacturer’s submitted price.²
b: Manufacturer’s submitted price.¹⁸
c: IQVIA²¹ (November 2018).
d: Saskatchewan Formulary²² (November 2018).
e: Assumes patient weight of 90 kg and wastage of excess medication in vials, if applicable.
f: Quebec formulary⁵ (September 2018) and IQVIA²¹ (November 2018): $18.9041.

From: Appendix 1, Cost Comparison

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Pharmacoeconomic Review Report: Risankizumab (Skyrizi): (AbbVie): Indication: For the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Jun. Table 4, Cost Comparison Table for the Treatment of Plaque Psoriasis.
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