Adalimumab Leads Cost-Efficiency Analysis of Approved HS Biologics Across Five Countries
Key Takeaways
- Adalimumab consistently ranked on the efficiency frontier for approved hidradenitis suppurativa (HS) biologics across five countries, demonstrating the strongest balance of cost and clinical efficacy.
- Secukinumab reached the efficiency frontier only under US wholesale acquisition cost assumptions, while bimekizumab was not cost-efficient in the evaluated pricing scenarios.
- The findings underscore how international pricing differences can substantially influence the value of biologic therapies and may inform future value-based pricing discussions in HS.
Adalimumab offers the most favorable balance of cost and clinical efficacy among currently approved monoclonal antibody therapies for moderate-to-severe hidradenitis suppurativa (HS), according to a new economic evaluation in JAMA Dermatology.
Investigators analyzed phase 3 efficacy data from six clinical trials evaluating adalimumab, secukinumab, and bimekizumab alongside publicly available drug pricing from the United States, Canada, France, Germany, and Australia. Using efficiency frontier analyses based on Hidradenitis Suppurativa Clinical Response (HiSCR)-50 and HiSCR-75 outcomes, the authors assessed the relative value of each biologic across different health care systems.
International Pricing Drives Value Differences in HS Biologics
Across all five countries, adalimumab 40 mg administered weekly consistently remained on the efficiency frontier for both HiSCR-50 and HiSCR-75 outcomes. Secukinumab 300 mg every four weeks appeared on the frontier only when US wholesale acquisition cost pricing was applied, while bimekizumab was economically dominated under most pricing scenarios.
Annual treatment costs varied between countries, ranging from approximately $11,345 for weekly adalimumab in Australia to $411,990 for bimekizumab dosed every two weeks in the U.S. Analyses adjusting for baseline disease severity produced findings similar to the primary analysis.
The authors noted that these results highlight significant international variation in biologic pricing.
"Among currently approved monoclonal antibody therapies for HS, adalimumab showed dominant cost-efficiency performance across multiple health systems," the investigators concluded. "These findings highlight substantial international variation in biologic drug pricing and provide a framework for value-based pricing in HS therapeutics."
Source
Pham J, et al. JAMA Dermatology. 2026. Doi:10.1001/jamadermatol.2026.2633