NICE Judges Apremilast Less Cost Effective than TNF Inhibitors Save

The National Institute for Heath and Care Excellence has turned down Otezla for coverage under the U.K. healthcare system for psoriatic arthritis. It cited concerns about cost-effectiveness, claiming it is less cost-effective with fewer quality-adjusted life-years than its competing tumor necrosis factor-alpha (TNF-a) inhibitors.

NICE claimed that TNF inhibitors are estimated to result in an incremental cost-effectiveness ratio (ICER) of £18,997 per QALY gained. By comparison, apremilast is estimated to produce an ICER of £23,487. The committee suggested apremilast should not be used prior the use of a TNF inhibitor due to greater costs.