Background and objective: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Treatment for moderate-to-severe HS includes biologic therapies (adalimumab and secukinumab), resulting in increased disease management costs. Our aim was to estimate the difference between secukinumab and adalimumab in terms of pharmacological costs and costs per responding patient 1 year into therapy from the Spanish National Health System (NHS) perspective.

Material and methods: We designed a decision tree comparing different treatment sequences, starting with a different first-line therapy. Patients switched arms based on achieving HS clinical response ≥ 50% (based on the SUNSHINE, SUNRISE, and PIONEER clinical trials results). A cohort of 100 patients was considered. Only treatment costs in euro (2023 base year) were considered for the analysis. A panel of experts validated the model structure and parameters.

Results: After 52-weeks into therapy, treatment sequences in the secukinumab group resulted in a total cost of euro1,198,912, corresponding to euro16,858 per responder. Total costs in the adalimumab treatment group were 2.5% higher, corresponding to euro19,701 per responder. A total of 80% of responders who start treatment with secukinumab do not change treatment, while only 31% of responders who start treatment with adalimumab stay on the same treatment.

Conclusions: The results of our financial assessment can help decision makers in selecting the most efficient therapeutic approach for treating patients with moderate-to-severe HS and poses secukinumab as a suitable therapeutic option for the Spanish NHS.