Interventions of interest:

  • Anti TNF agents: Adalimumab (Humira®, AbbVie), etanercept (Enbrel®, Amgen, Inc.), infliximab (Remicade®, Janssen)
  • Anti IL-17A agents: Secukinumab (Cosentyx®, Novartis), ixekizumab (Taltz®, Eli Lilly and Co.), brodalumab (SiliqTM, Valeant Pharmaceuticals and AstraZeneca)
  • Anti IL-12/23 agent: Ustekinumab (Stelara®, Janssen)
  • Anti PDE4 agent: Apremilast (Otezla®, Celgene)

Plaque psoriasis is a common disease that causes red, scaly, raised lesions on the skin, most commonly on the elbows, knees, scalp, and back. Psoriasis affects about 2% of the population and significantly decreases health-related quality of life. It is a chronic inflammatory condition associated with systemic diseases.

The New England CEPAC’s votes on value and subsequent policy roundtable discussion suggested that drug prices after rebates align well with added value for patients, and therefore insurers should consider limiting or abolishing step therapy coverage policies.

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Final Documents

Below you will find the final documents from the assessment review process:

“The evidence shows that targeted immunomodulators for patients with moderate to severe plaque psoriasis provide considerable improvement in quality of life and ability for people to function at work, in school, and in social activities. In addition, the net prices for these drugs after rebates are well aligned with the added value patients experience. As a consequence, it appears reasonable that insurers should provide more flexibility in coverage for these drugs, while at the same time it remains equally important that drug manufacturers avoid future price increases that would push more financial burden onto patients and health system budgets.”