The European Journal of Health Economics

, Volume 13, Issue 2, pp 145–156 | Cite as

Cost-effectiveness of treatment with etanercept for psoriasis in Sweden

  • Christopher Knight
  • Josephine Mauskopf
  • Mats Ekelund
  • Amitabh Singh
  • Shiyi Yang
  • Robert Boggs
Original Paper



To estimate the cost-effectiveness, from a Swedish societal perspective, of intermittent use of etanercept (Enbrel) with interruptions of use after 24 weeks compared to continuous use of adalimumab (Humira) as well as non-systemic standard of care in patients with moderate to severe psoriasis.


A Markov decision-tree model was constructed from clinical trials results. Patients starting etanercept, adalimumab, or non-systemic therapy moved through the model’s 10-years horizon. Model input parameters included clinical response rates. Outcome measures included direct and indirect costs and quality-adjusted life-years (QALYs).


The incremental total (direct and indirect) costs per QALY were 1,559,939 kr (€165,354) for adalimumab 40 mg every other week, compared with intermittent once-weekly Enbrel 50 mg, and 93,629 kr (€9,925) for once-weekly intermittent etanercept 50 mg compared with non-systemic standard of care.


This analysis showed that, with a 470,000 kr (€50,000) per QALY willingness-to-pay threshold, once-weekly etanercept 50 mg, used intermittently, is a cost-effective treatment for moderate to severe psoriasis compared with adalimumab and non-systemic standard of care.


Cost-effectiveness Psoriasis Etanercept Adalimumab Intermittent treatment QALY 

JEL Classification



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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Christopher Knight
    • 1
  • Josephine Mauskopf
    • 2
  • Mats Ekelund
    • 3
  • Amitabh Singh
    • 4
  • Shiyi Yang
    • 4
  • Robert Boggs
    • 4
  1. 1.RTI Health Solutions, Velocity House Business and Conference CentreSheffieldUK
  2. 2.RTI Health SolutionsResearch Triangle ParkUSA
  3. 3.Pfizer Inc.SolnaSweden
  4. 4.Pfizer Inc.CollegevilleUSA

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