Cost‐Effectiveness Evaluation of Early Versus Late Treatment With Dupilumab in Children and Adolescent With Severe Atopic Dermatitis in France
Jean Tardu, Marine Sivignon, Olfa Doghri, Noémie Allali, Jules Tavi, Anne-Lise Vataire, Kerry Noonan, Stéphanie Mallet, Pierre LevyBackground
Atopic dermatitis (AD) affects the quality of life (QoL) of children and adolescents in various domains. Although the burden of AD on children’s QoL is well established, evidence on the cost‐effectiveness of interventions in pediatric AD remains limited.
Objectives
The objective of this economic analysis is to investigate the cost‐effectiveness and clinical relevance of early versus late treatment of severe AD with dupilumab in addition to best supportive care (BSC).
Methods
A cost‐effectiveness model was adapted to the French context to compare over a 12‐year time horizon patients with severe AD treated from age 6 with dupilumab and BSC versus patients with severe AD treated from age 6 to 11 years with BSC who then initiate dupilumab from age 12. Clinical data were mainly derived from Phase 3 clinical trials, which evaluated the efficacy and safety of dupilumab in AD in children aged 6–11 and adolescents aged 12–17 years. Health‐related QoL inputs and resource use were obtained from the real‐world studies ECLAJUNIOR and ECLADO.
Results
The base case results showed a total gain of 1.26 quality‐adjusted life‐years (QALYs) with an incremental cost of €24,475 when comparing early versus late initiation of dupilumab. This resulted in an incremental cost‐effectiveness ratio (ICER) of 19,482 €/QALY gained. Results were generally robust to parameter variations in one‐way and probabilistic sensitivity analyses.
Conclusion
The analysis shows that dupilumab has a high probability of being cost‐effective in children 6 years and older who are suffering from severe AD in France.