---
title: "Imsidolimab in Generalized pustular psoriasis: cost-effectiveness analyses and utility weights"
description: "Published cost-effectiveness analyses and health-state utility weights for Imsidolimab in Generalized pustular psoriasis, each value quoted from the article: 8 cost-effectiveness analyses and 6 studies reporting utility weights. Analyses: Targeted biologics and apremilast versus no targeted treatment in moderate to severe plaque psoriasis, United States: Hendrix et al. (2018); Bimekizumab, narrowband UV-B phototherapy, and step therapy in moderate to severe plaque psoriasis, United States: Kong and Buzney (2026); Ixekizumab every 2 weeks and etanercept versus ixekizumab every 4 weeks in moderate to severe plaque psoriasis, United States: Udkoff and Eichenfield (2017); Ustekinumab versus etanercept in moderate to severe plaque psoriasis, United States: Villacorta et al. (2013); 4 further articles. Utility weights: Utility weights by PASI response and without targeted treatment, moderate to severe plaque psoriasis: Hendrix et al. (2018); Utility weights by PASI response and at baseline, moderate to severe plaque psoriasis: Udkoff and Eichenfield (2017); Utility weights by PASI response and for conventional systemic therapy, moderate to severe plaque psoriasis: Zhang et al. (2023); Utility weights by PASI response, severe plaque psoriasis: Villacorta et al. (2013); 2 further articles. Every value is a verbatim quote from the primary article it is shown with."
canonical: "https://www.evicenter.com/drugs/imsidolimab--generalized-pustular-psoriasis/cost-effectiveness-analyses"
published: "2026-10-22T07:49:06-04:00"
modified: "2026-10-22T07:49:06-04:00"
---
# Imsidolimab in Generalized pustular psoriasis: cost-effectiveness analyses and utility weights
Published cost-effectiveness analyses and health-state utility weights that a model of this product could cite, adapt, or compare against, grouped by how each article relates to the product and its indication. Every value is quoted from the article it cites, and section 3 lists the searches that found the articles.
## Overview
| Item | Detail |
| --- | --- |
| Literature searched | Tufts Medical Center Cost-Effectiveness Analysis Registry, searched October 21, 2026; the queries are listed in section 3. |
| Cost-effectiveness analyses | 8 |
| Studies reporting utility weights | 6 |
## 1 Cost-effectiveness analyses
### 1.1 Analyses of Imsidolimab
No evidence found.
### 1.2 Treatments for the same indication
No evidence found.
### 1.3 The same disease in other populations or settings
No evidence found.
### 1.4 Related diseases and analogous treatments
#### Targeted biologics and apremilast versus no targeted treatment in moderate to severe plaque psoriasis, United States: Hendrix et al. (2018)
Relevance: Evaluates TNF, IL-17, and IL-12/23 inhibitor biologics and apremilast in moderate to severe plaque psoriasis in the United States, covering the TNF and IL-17 inhibitor classes that section 2 lists as second-line and maintenance options in generalized pustular psoriasis.
> “We developed a Markov model to simulate patient outcomes as measured by quality-adjusted life-years (QALYs) and health care costs over a 10-year period.”
> “Since our drugs of interest are usually reserved for patients who have failed topical drugs, phototherapy, and methotrexate, we included only targeted drugs in the model.”
> “To allow our study to be relevant to coverage decisions, we used a payer perspective and, therefore, considered direct medical costs only.”
> “Total treatment costs were summed over 10 years using a 3% annual discount rate.”
> “Wholesale acquisition drug costs were discounted by a class-specific, empirically derived rebate percentage off of 2016 costs.”
> “Base-Case Estimates of Cost, QALYs, and Incremental Cost-Effectiveness with 10-Year Time Horizon”
> “Apremilast 137,080 6.403 81,033 (vs. no treatment)”
> “Etanercept 181,387 6.505 433,248 (vs. apremilast)”
> “Adalimumab 194,180 6.681 72,703 (vs. etanercept)”
> “Infliximab 176,695 6.804 Dominant”
> “Ustekinumab 255,422 6.959 Dominated”
> “Secukinumab 208,727 7.045 132,913 (vs. infliximab)”
> “Brodalumab 236,690 7.173 217,589 (vs. secukinumab)”
> “Ixekizumab 243,938 7.208 208,872 (vs. brodalumab)”
> “Our probabilistic sensitivity analysis indicated that apremilast and infliximab are likely to provide the most net monetary benefit at willingness-to-pay (WTP) thresholds near $100,000 (Figure 3).”
Source: [Hendrix et al. (2018)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10398188/)
#### Bimekizumab, narrowband UV-B phototherapy, and step therapy in moderate to severe plaque psoriasis, United States: Kong and Buzney (2026)
Relevance: Compares bimekizumab, an IL-17 inhibitor, with home or office narrowband UV-B phototherapy and with step therapy from phototherapy to biologics in moderate to severe plaque psoriasis from a United States payer perspective, treatment classes that section 2 describes for generalized pustular psoriasis.
Access: Not open access
Not quoted: The results are reported in the full text, which is closed access.
> “Simulation modeling study in patients with moderate to severe plaque psoriasis (Psoriasis Area and Severity Index [PASI] ≥12) using published estimates of efficacy, costs, and mappings between PASI score and quality-adjusted life-years (QALYs) from 2013 through 2025.”
> “One year of treatment with a representative biologic (bimekizumab), narrowband UV-B phototherapy (home or office) or a step-therapy regimen where patients initiated phototherapy for 16 weeks and switched to biologics if PASI90 (an improvement in PASI score of ≥90%) was not achieved, continuing the more effective therapy.”
> “Main outcomes were PASI reductions at 32 weeks, QALYs monetized as $100 000 per QALY, and total treatment costs to payers.”
> “Mean (SD) QALY gains were 0.24 (0.08) for biologics, 0.18 (0.09) for phototherapy, and 0.23 (0.06) for step therapy.”
> “Mean (SD) annual total costs were $84 034 (0) for biologics, $14 760 (0) for office phototherapy, and $6222 (0) for home phototherapy.”
> “From the payer perspective, mean (SD) net willingness to pay was highest for home phototherapy ($11 694 [$9421]) and lowest for biologics (-$59 926 [$7916]).”
> “Phototherapy remained cost-effective for payers.”
Source: [Kong and Buzney (2026)](https://pubmed.ncbi.nlm.nih.gov/41739454/)
#### Ixekizumab every 2 weeks and etanercept versus ixekizumab every 4 weeks in moderate to severe plaque psoriasis, United States: Udkoff and Eichenfield (2017)
Relevance: Evaluates the IL-17 inhibitor ixekizumab against etanercept, a TNF inhibitor, in moderate to severe plaque psoriasis in the United States, a class section 2 lists for maintenance treatment of generalized pustular psoriasis.
> “We constructed a Markov model to calculate the cost-effectiveness of etanercept and ixekizumab treatments from a limited societal perspective”
> “The end-point was the calculation of the incremental cost effectiveness ratios (ICER) of 12-week courses of bi-weekly etanercept, ixekizumab every 2 weeks and ixekizumab every 4 weeks over a 60-week time horizon (5 Markov cycles).”
> “Costs in 2016 U.S. dollars were compared using the effectiveness of treatments as measured by the quality adjusted life years (QALY) gained.”
> “We used a standard annual discount of 3.0% for both costs and QALYs per previous analysis.”
> “This simulation demonstrated ixekizumab every 4 weeks to have a mean cost of $79,734.18 and effectiveness of 0.857 QALY over the 60-week time horizon”
> “Ixekizumab every 2 weeks had a mean cost of $101,108.87 with an incremental effectiveness of 0.006 and an ICER of $3,422,386.62 when compared to ixekizumab every 4 weeks.”
> “The bi-weekly etanercept cost was $108,415.63 with a mean effectiveness of 0.825 QALY and an ICER of -$913,870.47 when compared to ixekizumab every 4 weeks.”
> “The negative ICER in this instance is indicative of etanercept therapy being vastly more expensive and less effective than ixekizumab every 4 weeks ( dominated ).”
Source: [Udkoff and Eichenfield (2017)](https://pmc.ncbi.nlm.nih.gov/articles/PMC5802402/)
#### Ustekinumab versus etanercept in moderate to severe plaque psoriasis, United States: Villacorta et al. (2013)
Relevance: Evaluates ustekinumab against etanercept in moderate to severe plaque psoriasis in the United States, with health states defined by psoriasis area and severity index response.
> “This study evaluated the cost effectiveness of ustekinumab compared with etanercept from a US societal perspective.”
> “A Markov model was constructed to simulate the incremental cost per quality-adjusted life-year (QALY) gained every 12 weeks over a base-case 3-year time horizon.”
> “A hypothetical patient cohort was based on the characteristics of the phase III Active Comparator Psoriasis Trial (ACCEPT).”
> “All costs were adjusted to 2011 US dollars. A 3 % annual discount rate was applied to costs and QALYs.”
> “For the base-case 3-year time horizon, the incremental cost-effectiveness ratio comparing ustekinumab 90 mg with etanercept 50 mg was US$384,401 per QALY gained.”
> “Ustekinumab 45 mg dominates etanercept 50 mg for the same time horizon.”
> “The probabilistic sensitivity analysis suggests ustekinumab 90 mg has a minimal (4 %) chance of being cost effective compared with etanercept 50 mg at a willingness-to-pay threshold of US$150,000 per QALY improvement.”
> “For the same threshold, ustekinumab 45 mg has a high (88 %) chance of being cost effective compared with etanercept 50 mg.”
Source: [Villacorta et al. (2013)](https://pubmed.ncbi.nlm.nih.gov/23975739/)
#### Secukinumab versus other biologics in moderate to severe plaque psoriasis, China: Zhang et al. (2023)
Relevance: Evaluates secukinumab against guselkumab, ixekizumab, ustekinumab, adalimumab, infliximab, and etanercept in moderate to severe plaque psoriasis from a Chinese healthcare system perspective, spanning the IL-17, IL-23, and TNF inhibitor classes section 2 lists for generalized pustular psoriasis.
> “A decision-tree (first year)/Markov model (subsequent years), with an annual cycle, was implemented over a lifetime horizon.”
> “The base-case analysis assessed the cost-effectiveness of secukinumab compared with other biologics from the Chinese healthcare system perspective.”
> “An annual discount rate of 5% was applied to both costs and outcomes”
> “All cost inputs were inflated to 2022 using the Chinese consumer price index (Table 5).”
> “Costs, QALYs, and ICER values for patients with moderate-to-severe plaque psoriasis”
> “Secukinumab ¥231,477 12.334”
> “Adalimumab ¥284,034 12.120 Dominates”
> “Infliximab ¥369,555 12.330 Dominates”
> “Ustekinumab ¥233,666 12.098 Dominates”
> “Ixekizumab ¥228,320 12.284 ¥62,323/QALY”
> “Guselkumab ¥272,709 12.202 Dominates”
> “Yisaipu ¥254,220 11.750 Dominates”
> “Therefore, secukinumab was a cost-effective option compared with ixekizumab at a WTP threshold of ¥257,094 per QALY gained (Table 6).”
Source: [Zhang et al. (2023)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10613169/)
#### Sequential IL-17 inhibitors versus methotrexate or ciclosporin in moderate to severe plaque psoriasis, Thailand: Dilokthornsakul et al. (2024)
Relevance: Evaluates IL-17 inhibitors against methotrexate or ciclosporin in moderate to severe plaque psoriasis in Thailand, comparing a biologic class with the conventional systemic agents section 2 lists for generalized pustular psoriasis.
> “A cost-utility analysis was conducted from a societal perspective with a lifetime horizon. A decision tree with a Markov model was developed ( Fig 1 ).”
> “Patients with moderate-to-severe psoriasis aged 40 years old with PASI score of ≥ 15 who had an inadequate response to conventional systematic treatments were eligible.”
> “Methotrexate or ciclosporin was used as standard of care (SoC).”
> “All costs were inflated to the 2021 value using the consumer price index and converted to US dollar ($) using the average exchange rate in the year 2021 which was 0.0313 $/Thai baht (THB).”
> “All analyses applied an annual discount rate of 3% for both cost and QALY”
> “Treatments Cost (THB) Life-year QALY Incremental cost (THB) Incremental cost ($) Incremental QALY ICER (THB/QALY) ICER ($/QALY)”
> “Sequence1 2,646,675 20.589 16.484 1,863,287 58,321 2.995 621,373 19,449”
> “Sequence2 3,808,175 20.589 16.649 3,024,787 94,676 3.160 957,258 29,962”
> “Sequence3 4,552,700 20.589 16.318 3,769,313 117,979 2.829 1,332,262 41,700”
> “Sequence 1: Secukinumab followed by Ixekizumab/Brodalumab then Guselkumab, Sequence 2: Ixekizumab followed by Secukinumab /Brodalumab then Guselkumab, Sequence 3: Brodalumab followed by Ixekizumab/Secukinumab then Guselkumab”
> “At the current willingness-to-pay of 160,000 THB/QALY, no sequential IL-17 inhibitor was cost-effective compared to SoC.”
Source: [Dilokthornsakul et al. (2024)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11315331/)
#### Apremilast and biologics versus standard of care in moderate to severe plaque psoriasis after conventional systemic therapy, Canada: CADTH (2017)
Relevance: A Canadian health technology assessment that evaluates apremilast, TNF inhibitors, ustekinumab, and secukinumab against standard care with topical agents and phototherapy in moderate to severe plaque psoriasis.
> “The manufacturer submitted a cost-utility analysis (CUA) comparing apremilast and biologics (adalimumab, etanercept, infliximab, subsequent entry biologic [SEB] infliximab, secukinumab, ustekinumab) with standard of care (SoC) (defined as receiving topical agents, phototherapy, and routine physician visits)”
> “The CUA was based on a Markov state transition model using a 10-year horizon and 28-day cycle length. All costs and outcomes were discounted at a rate of 5% annually, and the analysis was undertaken from the perspective of the Canadian publicly funded health care system.”
> “SUMMARY OF RESULTS OF THE MANUFACTURER’S BASE CASE”
> “Apremilast $24,101 5.83 $17,823 0.21 $83,480 $83,480”
> “Adalimumab $56,509 6.07 $50,331 0.45 $110,662”
> “Etanercept $57,646 6.03 $51,368 0.41 $124,066”
> “SEB infliximab $63,740 6.23 $57,462 0.61 $94,062 $99,747”
> “Ustekinumab $68,986 6.15 $62,708 0.53 $117,253”
> “Secukinumab $73,657 6.22 $67,379 0.60 $112,900”
> “Infliximab $116,042 6.23 $109,764 0.61 $179,676”
> “Based on CDR reanalyses accounting for some of the aforementioned limitations (i.e., correction of SoC utility coding error, alternative monitoring costs and use of a 5-year horizon), apremilast was associated with an ICUR of $105,935 per QALY versus SoC, and was extendedly dominated by SoC and SEB infliximab.”
> “Based on available clinical evidence, apremilast is dominated by MTX.”
Source: [CADTH (2017)](https://www.cda-amc.ca/sites/default/files/cdr/pharmacoeconomic/SR0478_Otezla_PE_Report_e.pdf)
#### Ixekizumab-first versus secukinumab-first biologic sequences in moderate to severe plaque psoriasis, United Kingdom: Johansson et al. (2018)
Relevance: Evaluates sequences of biologics beginning with ixekizumab or secukinumab and ending in best supportive care in moderate to severe plaque psoriasis in the United Kingdom, a sequencing structure a model of maintenance treatment after a generalized pustular psoriasis flare could adapt.
> “A Markov model with a lifetime horizon was developed to compare the cost-effectiveness of ixekizumab and secukinumab treatment sequences: ixekizumab → ustekinumab → infliximab → best supportive care (BSC) vs secukinumab → ustekinumab → infliximab → BSC.”
> “The model used monthly cycles, and included four health states: trial period, treatment maintenance, BSC, and death.”
> “An annual discontinuation rate of 20% was assumed for maintenance therapy.”
> “The ixekizumab sequence provided cost savings of £898 (£176,203 vs 177,101) [year 2015 values] and gained 0.03 more quality-adjusted life-years (QALYs: 1.45 vs 1.42) vs the secukinumab sequence over the lifetime horizon.”
> “Probabilistic sensitivity analysis showed an 89.8% likelihood that the ixekizumab sequence would be cost-effective at a threshold of £20,000 per QALY gained.”
> “The analysis used list prices for drugs rather than confidential, preferentially priced Patient Access Scheme costs.”
Source: [Johansson et al. (2018)](https://pubmed.ncbi.nlm.nih.gov/29873270/)
## 2 Utility weights
### 2.1 Utility weights from analyses of Imsidolimab
No evidence found.
### 2.2 Utility weights for the same indication
No evidence found.
### 2.3 Utility weights for the same disease in other populations or settings
No evidence found.
### 2.4 Utility weights for related diseases and analogous treatments
#### Utility weights by PASI response and without targeted treatment, moderate to severe plaque psoriasis: Hendrix et al. (2018)
Relevance: EQ-5D utilities by psoriasis area and severity index response band and for plaque psoriasis without a targeted agent, from a United States model of psoriasis biologics.
> “Utilities for the base-case scenario were obtained from an analysis of EQ-5D data in 3,231 patients enrolled in 5 randomized controlled trials evaluating secukinumab in moderate to severe plaque psoriasis.”
> “The EQ-5D was measured alongside PASI in the secukinumab trials, and the improvement in PASI score was mapped onto the EQ-5D, resulting in a utility of 0.906 for PASI 90-100, 0.868 for PASI 75-89, 0.835 for PASI 50-74, and 0.751 for PASI improvement of less than 50%.”
> “The utility for patients not receiving any targeted agent was 0.642, based on this study’s estimate of its population’s baseline (i.e., untreated) utility.”
Source: [Hendrix et al. (2018)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10398188/)
#### Utility weights by PASI response and at baseline, moderate to severe plaque psoriasis: Udkoff and Eichenfield (2017)
Relevance: EQ-5D utilities by psoriasis area and severity index response band and at baseline in moderate to severe plaque psoriasis, from a United States model.
> “We converted the PASI percent improvement into health utility scores using EuroQol 5-Dimension Health Questionnaire (EQ-5D) health utility scores produced from the UNCOVER trial’s data.”
Source: [Udkoff and Eichenfield (2017)](https://pmc.ncbi.nlm.nih.gov/articles/PMC5802402/)
| Health state | Utility |
| --- | --- |
| “Health utility for PASI response of 100%” | “0.849” |
| “Health utility for PASI response of 90–<100%” | “0.844” |
| “Health utility for PASI response of 75–<90%” | “0.826” |
| “Health utility for PASI response of <75%” | “0.737” |
| “Baseline health utility” | “0.660” |
Source: [Udkoff and Eichenfield (2017)](https://pmc.ncbi.nlm.nih.gov/articles/PMC5802402/)
#### Utility weights by PASI response and for conventional systemic therapy, moderate to severe plaque psoriasis: Zhang et al. (2023)
Relevance: EQ-5D utilities by psoriasis area and severity index response band in moderate to severe plaque psoriasis, from a model that includes IL-17 and IL-23 inhibitors.
> “An ordinal logistic regression method was implemented to map DLQI data to EQ-5D-3L-based utility estimates using the Chinese EQ-5D value set (Table 4)”
> “Disutilities associated with methotrexate and cyclosporine, and the proportion of patients using each therapy are available in Table 4.”
Source: [Zhang et al. (2023)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10613169/)
| Health state | Utility |
| --- | --- |
| “PASI < 50” | “0.651” |
| “PASI 50–74” | “0.755” |
| “PASI 75–89” | “0.880” |
| “PASI 90–99” | “0.937” |
| “PASI 100” | “0.967” |
| “PASI ≥ 75” | “0.934” |
| “Methotrexate” | “0.971” |
| “Cyclosporine” | “0.912” |
Source: [Zhang et al. (2023)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10613169/)
#### Utility weights by PASI response, severe plaque psoriasis: Villacorta et al. (2013)
Relevance: Utilities by psoriasis area and severity index response in severe plaque psoriasis, from a United States model of ustekinumab against etanercept.
Access: Not open access
Not quoted: The utility weights are reported in the full text, which is closed access.
> “Costs, utilities, treatment strategy, and resource use estimates were obtained from relevant literature.”
Source: [Villacorta et al. (2013)](https://pubmed.ncbi.nlm.nih.gov/23975739/)
#### Baseline utility and utility gains by PASI response, moderate to severe plaque psoriasis: Barker et al. (2021)
Relevance: Baseline utility and incremental utility gains by psoriasis area and severity index response in moderate to severe plaque psoriasis, sourced from studies in moderate-to-severe psoriasis populations.
> “Each PASI response health state was associated with a different utility in the model such that higher PASI responses were associated with greater patient quality of life.”
> “Utilities were sourced from relevant studies with moderate-to-severe psoriasis populations.”
> “PASI score Incremental utility gain (from baseline)”
Source: [Barker et al. (2021)](https://pmc.ncbi.nlm.nih.gov/articles/PMC8556196/)
| Health state | Utility |
| --- | --- |
| “Baseline” | “0.59” |
| “< 50” | “0.05” |
| “50–74” | “0.19” |
| “75–90” | “0.24” |
| “> 90” | “0.28” |
Source: [Barker et al. (2021)](https://pmc.ncbi.nlm.nih.gov/articles/PMC8556196/)
#### Baseline utility weight and utility change by PASI response, moderate to severe plaque psoriasis: CADTH (2017)
Relevance: Baseline utility and utility change by psoriasis area and severity index response, based on SF-36 utilities from the apremilast trials, in moderate to severe plaque psoriasis, from a Canadian health technology assessment.
> “Each PASI response category was associated with a change in utility from baseline; values were based on Short Form (36) Health Survey (SF-36) utilities collected at baseline and week 16 during the apremilast trials (ESTEEM-1, ESTEEM-2, and LIBERATE).”
> “The baseline utility value of 0.7 was taken from literature sources.”
Source: [CADTH (2017)](https://www.cda-amc.ca/sites/default/files/cdr/pharmacoeconomic/SR0478_Otezla_PE_Report_e.pdf)
## 3 Search strategy
| Dataset | Query | Results |
| --- | --- | --- |
| Methods | imsidolimab | 0 |
| Ratios | imsidolimab | 0 |
| Ratios | "generalized pustular psoriasis" OR "pustular psoriasis" | 0 |
| Ratios | pustular | 0 |
| Ratios | spesolimab | 0 |
| Methods | pustular OR spesolimab | 0 |
| Weights | pustular OR spesolimab | 0 |
| Ratios | psoriasis | 286 |
| Ratios | "plaque psoriasis" | 115 |
| Ratios | psoriasis AND (guselkumab OR risankizumab OR tildrakizumab) | 48 |
| Ratios | guselkumab OR risankizumab OR tildrakizumab | 50 |
| Weights | psoriasis | 115 |
| Ratios | pustulosis OR erythrodermic OR "IL-36" OR interleukin-36 | 1740 |
| Methods | pustulosis | 0 |
| Weights | "psoriasis" AND flare | 0 |
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