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 policy recommendations repeat call for insurers to minimize step therapy requirements on these treatments that are priced in alignment with clinical benefits, but cautions manufacturers against the ongoing price increases that are beginning to threaten the cost-effectiveness of entire therapy class.

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Interventions of Interest:

  • Anti IL-23 agents: Guselkumab (Tremfya®, Janssen/Johnson & Johnson), tildrakizumab (Ilumya™, Sun Pharma), risankizumab (Skyrizi®, AbbVie)
  • Anti TNF agent: Certolizumab pegol (Cimzia®, UCB)

Final Documents

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

ICER’s Chief Scientific Officer Dan Ollendorf, PhD stated:

“Similar to the findings of our 2016 report, we again found that many targeted therapies offer benefit over non-targeted therapies, and we are able to further clarify which agents may be most effective. While many of these therapies currently represent reasonable value, patients continue to face insurance barriers that interfere with their access to these potentially life changing therapies, and recent price increases for many agents may further limit access. Insurers should work to expand access to therapies that are priced in accordance with their clinical benefits, and manufacturers must be transparent about the rationale behind any future price increases.”