ArticleDermatology and therapy2026
Cost-Effectiveness Analysis of Bimekizumab against Interleukin-23 Inhibitors in Patients with Plaque Psoriasis in Japan.
Article in Dermatology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPsoriasis is a chronic, inflammatory skin disease that significantly impairs patients' quality of life (QOL). Several biologics with varying mechanisms of action are approved for treating moderate-to-severe plaque psoriasis (PSO) in Japan; bimekizumab is the only one that selectively binds to and inhibits interleukin (IL)-17F in addition to IL-17A. However, there is currently no recommended biologics treatment sequence, and their high cost limits treatment accessibility. This study evaluated bimekizumab cost-effectiveness versus IL-23 inhibitors in patients with PSO in Japan from a public healthcare payer's perspective, and explored variables that affect cost-effectiveness.
methodsA cohort simulation, lifetime Markov model with 2-week cycles simulated the treatment pathway in adults with moderate-to-severe PSO who had an inadequate response to previous treatments. Bimekizumab was compared with the IL-23p19 inhibitors guselkumab, risankizumab, and tildrakizumab in the first line; brodalumab was the second-line treatment for all arms. Transition to second-line treatment was triggered by not achieving a ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75), or discontinuation due to adverse events. A network meta-analysis provided PASI response rates. QOL scores were derived from EuroQol 5-Dimension 3-Level health questionnaire responses from global bimekizumab phase 3 studies. Drug and management costs were estimated on the basis of Diagnosis Procedure Combination-based data in Japan; 2%/year discounting was applied to costs and quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios (ICERs) were calculated, and sensitivity and scenario analyses performed.
resultsBimekizumab generated the highest number of QALYs and was cost-effective against all IL-23 inhibitor comparators at a willingness-to-pay threshold of ¥5,000,000/QALY (bimekizumab versus guselkumab: ¥3,202,863/QALY; risankizumab: ¥4,732,268/QALY; tildrakizumab: ¥4,950,972/QALY). ICERs were sensitive to QOL scores, with PASI 100 QOL score being a key cost-effectiveness driver.
conclusionsFindings of the cost-effectiveness of bimekizumab against IL-23 inhibitors support the potential consideration of bimekizumab as a first-line treatment for moderate-to-severe PSO in Japan.
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