A Cost-per-Responder Analysis of Ritlecitinib vs Baricitinib in Severe Alopecia Areata.

Background: Ritlecitinib, a JAK3/TEC family kinase inhibitor, and baricitinib, a JAK1/2 inhibitor, are approved for treating severe alopecia areata (AA). Objective: Develop a cost-per-responder analysis for ritlecitinib and baricitinib for treating severe AA to estimate the budget impact based on clinical efficacy, available dosages, and pricing structure. Methods: A decision tree evaluated cost implications of once-daily ritlecitinib 50 mg, or baricitinib 2 mg and 4 mg treatment over 1 year from a US perspective. Drug costs were estimated using wholesale acquisition costs. Distribution across treatment and dosing options were based on real-world evidence. We defined shorter-term response as Severity of Alopecia Tool (SALT) score relative change from baseline ≥30% (SALT Δ≥30%; SALT Results: At Week 24, 52.10% of ritlecitinib initiators and 36.28% of baricitinib initiators achieved SALT Δ ≥30%; at Week 52, 40.26% and 30.63% of ritlecitinib and baricitinib initiators, respectively, achieved SALT ≤20. Baricitinib had a higher cost per responder than ritlecitinib at Weeks 24 ( Conclusions: Ritlecitinib 50 mg demonstrated a lower cost per responder than baricitinib 2 or 4 mg at Weeks 24 and 52, which may inform reimbursement or formulary inclusion of ritlecitinib for treating AA.