The Institute for Clinical and Economic Review (ICER) has issued a report recommending that dupilumab (Dupixent) offers good long-term value and important clinical benefit for patients with moderate-to-severe atopic dermatitis.
The Institute for Clinical and Economic Review (ICER) has issued a report recommending that dupilumab (Dupixent), Regeneron/Sanofi’s recently approved biologic medication, offers good long-term value and important clinical benefit for patients with moderate-to-severe atopic dermatitis and should be financially accessible to patients.
The report notes that atopic dermatitis, a common occurrence in children, can be a burden for patients and their families. The disease can have a significant impact on a person’s quality of life and its aesthetic impact can lead to social stress and isolation. Existing treatments for atopic dermatitis have well-known adverse events and may be of limited use for chronic disease, the report notes. In clinical trials for dupilumab for moderate-to-severe atopic dermatitis the report concluded that consistently across all trials, dupilumab met prespecified targets representing successful outcomes in 30% to 44% of patients, compared with 2% to 12% for placebo. Results were similar with weekly or every-other-week dosing, and in patients treated or not with topical corticosteroids.
ICER issued the report and summary of a May 2017 public meeting of the Midwest Comparative Effectiveness Public Advisory Council (Midwest CEPAC), a nationally recognized community forum that convenes 3 times per year at public meetings to review objective evidence reports and develop recommendations for how stakeholders can apply evidence to improve the quality and value of healthcare. ICER’s report also assessed the comparative clinical effectiveness of crisaborole (Pfizer’s Eucrisa, approved in December 2016) for mild-to-moderate disease. Insight into the patient experience was provided by the National Eczema Association.
During the public meeting, the Midwest CEPAC voted that the evidence was insufficient to assess the net health benefit of crisaborole compared with topical corticosteroid and topical calcineurin inhibitors. The Council voted that the evidence shows dupilumab to be superior to treatment with nonpharmacologic interventions or with cyclosporine for adults with moderate-to-severe atopic dermatitis for whom topical therapies have not been effective. Further, the Council found dupilumab to provide intermediate value for patients with moderate disease, and for a mixed population of patients with moderate-to-severe disease. For patients with severe disease, the Council voted that dupilumab is a high-value treatment.
The following key policy recommendations was the result of a roundtable discussion among experts, including payers, patients with atopic dermatitis, and a representative of a drug manufacturer: