Upadacitinib (Rinvoq): CADTH Reimbursement Recommendation [Internet]

Review
Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2022 Jun.

Excerpt

What Is the CADTH Reimbursement Recommendation for Rinvoq?: CADTH recommends that Rinvoq be reimbursed by public drug plans for the treatment of adults and adolescents 12 years of age and older with refractory moderate to severe atopic dermatitis (AD) if certain conditions are met.

Which Patients Are Eligible for Coverage?: Rinvoq should only be covered to treat patients who have previously tried and are refractory to, or who are ineligible or cannot tolerate, the highest tolerated dose of topical treatments for AD combined with phototherapy (where available), and at least 1 of methotrexate, cyclosporine, mycophenolate mofetil, or azathioprine.

What Are the Conditions for Reimbursement?: Rinvoq should only be reimbursed if prescribed by a dermatologist, allergist, clinical immunologist, or pediatrician, and the cost of Rinvoq is reduced.

Why Did CADTH Make This Recommendation?:

  1. In 4 clinical trials, treatment with Rinvoq reduced AD severity and symptoms compared to treatment with placebo.

  2. Rinvoq may meet some of the needs that are important to patients, including reducing AD severity and symptoms and improving health-related quality of life.

  3. Based on CADTH’s assessment of the health economic evidence, Rinvoq may not represent good value to the health care system at the public list price. The committee determined that there is not enough evidence to justify a greater cost for Rinvoq compared with dupilumab over the duration of treatment.

  4. Based on public list prices, Rinvoq is estimated to save the public drug plans approximately $62 million over the next 3 years.

What is Atopic Dermatitis?: AD is a condition that affects the skin. People with AD have dry, red skin that is extremely itchy. Constant scratching can cause the skin to split and bleed, which can cause skin infections. Oozing and weeping sores can also occur in more severe forms of AD. Severe dermatitis can be physically disabling or incapacitating and cause anxiety or depression. The lifetime prevalence of AD is estimated to be up to 17% in the Canadian population.

Unmet Needs in Atopic Dermatitis: There is no cure for AD, and treatment aims to provide symptom relief and control symptoms in the longer term. Although many treatments are approved in Canada to treat AD, symptoms may not be controlled with existing drugs in some patients. Other treatment options are needed for these patients.

How Much Does Rinvoq Cost?: Treatment with Rinvoq 15 mg is expected to cost approximately $17,768 per year. The 30 mg dose is expected to cost approximately $27,010 per year.

Publication types

  • Review