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J Dermatolog Treat. 2019 Dec;30(8):772-774. doi: 10.1080/09546634.2019.1573307. Epub 2019 Feb 12.

Institute for clinical and economic review (ICER) psoriasis update 2018: what it means for dermatologists treating moderate-to-severe plaque psoriasis.

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John A. Burns School of Medicine , University of Hawaii , Honolulu , Hawaii.
Medical College of Georgia , Augusta University , Augusta , GA , USA.
College of Medicine, University of Cinicinnati , Cincinnati , OH , USA.
Dermatology Research and Education Foundation , Irvine , CA , USA.


Objective: This paper aims to summarize the key findings of the updated report issued in August 2018 by the Institute of Clinical and Economic Review (ICER) regarding the clinical efficacy and budget impact of various immunomodulators. Methods: This paper specifically focuses on the inclusion of two new biologics, guselkumab and certolizumab in the context of their relative cost-effectiveness using analyses on sequential implementation of specific first- and second-line therapies. Results: The ICER found that initiating biologic therapy with an IL-17 inhibitor or guselkumab results in the most clinical improvement, but is also associated with higher costs. The ICER also found that guselkumab and certolizumab would need to be discounted significantly in order to achieve cost-effectiveness by standard metrics of $50,000-$150,000 per QALY. Conclusion: The ICER report demonstrates a need for more consensus guidelines in the use of biologics in the treatment of psoriasis, and perhaps consideration of costs within these guidelines.


ICER; Psoriasis; cost-effectiveness

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