Content » Vol 100, December

Investigative Report

Health Economic Consequences of a Tightly Controlled Dose Reduction Strategy for Adalimumab, Etanercept and Ustekinumab Compared with Standard Psoriasis Care: A Cost-utility Analysis of the CONDOR Study

Selma Atalay, Juul M.P.A. van den Reek, Marisol E. Otero, Marcellus D. Njoo, Johannes M. Mommers, Paul M. Ossenkoppele, Marjolein I. Koetsier, Maartje M. Berends, Peter C.M. van de Kerkhof, Hans M.M. Groenewoud, Alfons A. den Broeder, Elke M.G.J. de Jong, Wietske Kievit
DOI: 10.2340/00015555-3692


A dose reduction strategy for adalimumab, etanercept and ustekinumab in patients with psoriasis who have stable and low disease activity has recently been compared with usual care in the CONDOR study (CONtrolled DOse Reduction) of biologics in patients with psoriasis with low disease activity. The aim of the current study was to perform a cost-utility analysis with a 12-month time horizon alongside this trial, using prospectively measured healthcare costs and quality-adjusted life years, based on Short-Form Six-Dimension utilities. Bootstrap analys­es were used to calculate the decremental cost-utility ratio and the incremental net monetary benefit. The dose reduction strategy resulted in a mean cost saving of €3,820 (95th percentile –€3,099 to –€4,509) per patient over a period of 12 months. There was an 83% chance that dose reduction would result in a reduction in quality adjusted life years (mean –0.02 (95th percentile –0.06 to 0.02). In conclusion, dose reduction of biologics resulted in substantial cost savings with an acceptable reduction in quality of life.


Psoriasis is a chronic inflammatory skin disease with a substantial impact on patients and on healthcare expenditure. This study evaluated the cost-effectiveness of a dose reduction strategy for adalimumab, etanercept and ustekinumab vs standard care over a 12-month period in patients with psoriasis in the Netherlands. Analysis showed that this dose reduction strategy resulted in relevant cost savings with a minimal decrease in quality adjusted life years.

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