Use of Ruxolitinib Cream Results in Economic Benefits Compared with Dupilumab in Treatment of Patients with Atopic Dermatitis Meeting Severity Thresholds for Systemic Therapy.

introductionBoth topical and systemic treatments can be used to manage atopic dermatitis (AD) in patients with moderate AD. This study evaluates the cost of ruxolitinib cream versus dupilumab in patients with moderate AD eligible for topical or systemic therapy.

methodsAn economic model based on a post hoc analysis of the TRuE-AD1/2 trials compared costs of topical and systemic treatments for moderate AD. It included patients aged ≥ 12 years with Investigator's Global Assessment (IGA) = 3, Eczema Area and Severity Index (EASI) ≥ 16, and body surface area (BSA) ≥ 10%, matching dupilumab trial criteria. The 2-year model, from a payer perspective, considered only medication acquisition costs.

resultsPatients meeting the target profile averaged 26.5 years old, with 53% female. In addition to IGA = 3, they had mean (SD) BSA of 18% (1.9%) and EASI of 19.3 (2.9). They had lived with AD for 18.2 years on average; 68.8% had facial involvement, 65.6% had used high-potency topical corticosteroids, and 40.6% had used systemic corticosteroids. Under model assumptions, patients using 1.5% ruxolitinib cream would utilize on average 9.0 tubes (60 g each) in year 1, costing $18,407 (95% CI $15,296-$21,518). Fully adherent dupilumab users would need 27 injections, costing $51,343. In year 2, estimated costs were $10,582 (95% CI $7955-$13,209) for ruxolitinib cream and $49,442 for dupilumab. Differences persisted across all sensitivity analyses.

conclusionsThis model demonstrates that 1.5% ruxolitinib cream reduces treatment costs by over 80% compared to dupilumab in patients with moderate AD eligible for systemic therapy. Combined with comparable efficacy, these savings position ruxolitinib cream as a cost-effective treatment option.