| Summary: | Ixekizumab (Taltz) is a humanized anti-interleukin (IL)-17A monoclonal antibody indicated for the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systematic therapy or phototherapy. The manufacturer is requesting listing of ixekizumab for adult patients in line with the indication. The recommended starting dose of ixekizumab is 160 mg, followed by 80 mg every two weeks for 12 weeks, and then 80 mg every four weeks. Ixekizumab is available as an 80 mg/1 mL pre-filled pen or pre-filled syringe, at a confidential price of $1,519. At the recommended dose, ixekizumab costs $27,342 in the first year of treatment and $19,747 in the each subsequent year. The manufacturer submitted a cost-utility analysis comparing ixekizumab and other biologic drugs available for the treatment of plaque psoriasis with standard of care (SoC, defined as combination treatment with methotrexate and phototherapy) in adult patients with moderate to severe plaque psoriasis who are candidates for systematic therapy. The analysis was based on a Markov state-transition model using a 45-year time horizon and undertaken from the perspective of the Canadian publicly funded health care system. The manufacturer reported that, compared with treatment with SoC, ixekizumab has an incremental cost-utility ratio (ICUR) of $113,023 per quality-adjusted life-year (QALY). When considering all comparators using a sequential analysis, subsequent entry biologic (SEB) infliximab is associated with the lowest ICUR ($85,983 per QALY versus SoC), followed by ixekizumab ($346,946 per QALY versus SEB infliximab). All other comparator drugs were ruled out, as they were either dominated or extendedly dominated (i.e., they were more costly and less effective than one or more comparators)
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