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The introduction of biosimilars can be expected to increase the accessibility of biologics to patients with the highest burden of disease associated with psoriasis, assuming that they demonstrate similarity and

systemic agents. In a study performed on 236 Finnish psoriasis patients, total medication costs were 1083 € per year per patient. Topical treatments were the most often purchased medication and they comprised 18% of the total medication costs, whereas biologics were used only by 5% of patients, but they accounted for 67% of total medication costs.36


8. Szepietowski J et al. Secukinumab 300 mg shows superior efficacy across subject body weight groups: Pooled analysis of phase 3 ERASURE and FIXTURE trials. J Am Acad Dermatol 2015;(5 Suppl 1):AB248.

9. Garcia-Doval I et al. Risk of serious adverse events associated with biologic and nonbiologic psoriasis systemic therapy: patients ineligible vs eligible for randomized controlled trials. Arch Dermatol 2012;148(4):463–70.

10. Spelman L et al. Secukinumab demonstrates sustained efficacy in moderate to severe plaque psoriasis across disease severity subgroups. J Am Acad Dermatol 2015;(5 Suppl 1):AB248.

interchangeability to reference products, under acceptable patient cost-sharing agreements in some cases.

National and supranational guidelines integrate scientific evidence derived from registries, post-marketing cohort studies, clinical trials and other sources, and provide a valuable contribution to therapeutic decisions. Prescriptions should be tailored to achieve the maximum benefit for each individual patient, taking into account not only speed of action, maintenance of effect and safety considerations, but also the economic benefit given to patient and society the and sustainability of reimbursement or acquisition cost, especially in the context of care provided by national health services.

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2. Lebwohl MG et al. Patient perspectives in the management of psoriasis: results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey. J Am Acad Dermatol 2014;70(5):871–81.e1–30.

3. Girolomoni G et al. Early intervention in psoriasis and immune-mediated inflammatory diseases: A hypothesis paper. J Dermatolog Treat 2015;26(2):103–12.

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7. Puig L. Obesity and psoriasis: body weight and body mass index influence the response to biological treatment. J Eur Acad Dermatol Venereol

11. Gladman DD et al. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis 2005;64:ii14–ii17.

12. Gottlieb AB. Secukinumab improves physical function in subjects with plaque psoriasis and psoriatic arthritis: Results from two randomized, Phase 3 trials. J Drugs Dermatol 2015;14(8):821–33.

13. Papp KA et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet 2008;371:1675–84.

14. Nash P et al. Updated guidelines for the management of axial disease in psoriatic arthritis. J Rheumatol 2014;41(11):2286–9.

15. Mazzotta A et al. Efficacy and safety of etanercept in psoriasis after switching from other treatments: an observational study. Am J Clin Dermatol 2009;10:319–24.

16. López-Ferrer A et al. Adalimumab for the treatment of psoriasis in real life: a retrospective cohort of 119 patients at a single Spanish centre. Br J Dermatol 2013;169(5):1141–7.

17. Puig L, Ruiz-Salas V. Long-term efficacy, safety and drug survival of ustekinumab in a Spanish cohort of patients with moderate to severe plaque psoriasis. Dermatology 2015;230(1):46–54.

18. Griffiths C et al. Secukinumab shows efficacy in subjects regardless of previous exposure to biologic therapy: A pooled subanalysis from four phase 3 clinical trials in psoriasis. J Am Acad Dermatol 2015;(5 Suppl 1):AB251.

19. Schmitt J et al. Efficacy and safety of systemic treatments for moderate-to-severe psoriasis: meta-analysis of randomized controlled trials. Br J Dermatol 2014;170(2):274–303.

20. Puig L et al. Efficacy of biologics in the treatment of moderate-to-severe plaque psoriasis: a systematic review and meta-analysis of randomized controlled trials with different time points. J Eur Acad Dermatol Venereol 2014;28(12):1633–53.

21. Nast A et al. Efficacy and safety of systemic long-term treatments for moderate-to-severe psoriasis: A systematic review and meta-analysis. J Invest Dermatol 2015;Jun 5 [Epub ahead of print].

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results of two phase 3 trials. N Engl J Med 2014;371(4):326–38.

23. Thaçi D et al. Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial. J Am Acad Dermatol. 2015;73(3):400–9.

24. Griffiths CE et al; ACCEPT Study Group. Comparison of ustekinumab and etanercept for moderate-to- severe psoriasis. N Engl J Med 2010;362(2):118–28.

25. Barker J et al. Efficacy and safety of infliximab vs. methotrexate in patients with moderate-to-severe plaque psoriasis: results of an open-label, active-controlled, randomized trial (RESTORE1). Br J Dermatol 2011;165(5):1109–17.

26. Nast A et al. Which antipsoriatic drug has the fastest onset of action? Systematic review on the rapidity of the onset of action. J Invest Dermatol 2013;133(8):1963–70.

27. Gniadecki R et al. Comparison of long-term drug survival and safety of biologic agents in patients with psoriasis vulgaris. Br J Dermatol 2015;172(1):244–52.

28. Warren RB et al. Differential drug survival of biologic therapies for the treatment of psoriasis: A prospective observational cohort study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol 2015;Jun 8 [Epub ahead of print].

29. Hsu L, Armstrong AW. Anti-drug antibodies in psoriasis: a critical evaluation of clinical significance and impact on treatment response. Expert Rev Clin Immunol 2013;9(10):949–58.

30. Jullien D, Prinz JC, Nestle FO. Immunogenicity of biotherapy used in psoriasis: the science behind the scenes. J Invest Dermatol 2015;135(1):31–8.

31. Reich K et al. Secukinumab, a novel anti- interleukin-17A antibody, exhibits low immunogenicity during long-term treatment in subjects with psoriasis. Gene to Clinic, London, 2014 Poster P103. doi/10.1111/bjd.13488/pdf.

32. Hsu L, Snodgrass BT, Armstrong AW. Antidrug antibodies in psoriasis: a systematic review. Br J Dermatol 2014;170(2):261–73.

33. Ben-Horin S et al. Cross-immunogenicity: antibodies to infliximab in Remicade-treated patients with IBD similarly recognise the biosimilar Remsima. Gut 2015;Apr 20 [Epub ahead of print].

34. Farhangian ME, Feldman SR. Immunogenicity of biologic treatments for psoriasis: Therapeutic consequences and the potential value of concomitant methotrexate. Am J Clin Dermatol 2015;16(4):285–94.

35. National Institute for Health and Care Excellence. Secukinumab for treating moderate to severe plaque psoriasis. NICE technology appraisal guide (TA350). (accessed 20 August 2015).

36. Mustonen A et al. The costs of psoriasis medications. Dermatol Ther (Heidelb) 2013;3(2):169–77.

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