为了评估阻断IL-17F和IL-17A的生物相似制剂Bimekizumab在针对银屑病性关节炎（PsA）的治疗中与生物类和靶向合成疾病修饰抗风湿药（DMARD）的成本效益，研究从瑞典医疗系统的角度创造了一个马尔可夫模型，模拟了生物类DMARD-原始状态或肿瘤坏死因子抑制剂经验状态下的PsA患者在终身范围内的临床路径。治疗反应被描述为达到美国风湿病学会50%（ACR50%）和银屑病面积和严重程度指数75%（PASI75%）的改善，以及健康评估问卷-残疾指数（HAQ-DI）得分的变化。Bimekizumab的疗效信息取自BE OPTIMAL（生物类DMARD-原始状态）和 BE COMPLETE（肿瘤坏死因子抑制剂经验状态）的临床试验，而网络荟萃分析（NMA）提供了相比较药物的疗效信息。资源利用和药物成本信息则来自于瑞典的出版研究和药物零售价格数据库。在每年0.5个QALY的支付意愿阈值为€50,000。在生物类DMARD-原始状态的患者中，除了英夫利西单抗（Infliximab）（14.22）之外，Bimekizumab取得了更好的生命质量调整年份（QALY）（14.08），并在成本效益上超过了间格列古单抗（Guselkumab）（每4和8周）、伊克匹随单抗（Ixekizumab）、席库单抗（Secukinumab）300mg、乌斯替可单抗（Ustekinumab）45mg和90mg，也在与里西度单抗（Risankizumab）、托法替尼（Tofacitinib）、乌帕达替尼（Upadacitinib）和肿瘤坏死因子抑制剂（TNFis）（除了阿达木单抗类似生物制剂）的成本效益之上。在肿瘤坏死因子抑制剂经验状态的患者中，Bimekizumab的生命质量调整年份（QALY）（13.56）高于其他药物，除了塞托利珠单抗（Certolizumab Pegol）（13.84），并在成本效益之上超过了伊克匹随单抗和席库单抗（300mg），同时对所有其他IL-17A、IL-23和JAK抑制剂均具有成本效益。一个网络荟萃分析（NMA）提供了相互比较的疗效估计。由于在PsA的疾病管理和HAQ-DI分数的间接成本的证据不足，以及顺序临床试验中的证据，该研究使用了类似联合疾病中的非PsA成本数据，并假设一个主动治疗后的最佳支持治疗。Bimekizumab在瑞典对于大多数银屑病性关节炎的可用治疗方法都具有成本效益，不论是否有过既往的TNF抑制剂暴露。

To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective.A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naïve or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was obtained from the BE OPTIMAL (bDMARD-naïve) and BE COMPLETE (TNFi-experienced) trials while a network meta-analysis (NMA) informed the efficacy of the comparators. Resource use and drug costs were obtained from published studies and databases of drug retail prices in Sweden. A willingness-to-pay threshold of €50,000 per quality-adjusted life year (QALY) was applied.In bDMARD-naïve patients, bimekizumab achieved greater QALYs (14.08) than with all comparators except infliximab (14.22), dominated guselkumab every 4 and 8 weeks, ixekizumab, secukinumab 300 mg, ustekinumab 45 mg and 90 mg, and was cost-effective against risankizumab, tofacitinib, upadacitinib and TNFis, except adalimumab biosimilar. In TNFi-experienced patients, bimekizumab led to greater QALYs (13.56) than all comparators except certolizumab pegol (13.84), and dominated ixekizumab and secukinumab 300 mg while being cost-effective against all other IL-17A-, IL-23- and JAK inhibitors.An NMA informed the comparative effectiveness estimates. Given gaps in evidence of disease management and indirect costs specific to HAQ-DI scores, and sequential clinical trial evidence in PsA, non-PsA cost data from similar joint conditions were used, and one line of active treatment followed by best supportive care was assumed.Bimekizumab was cost-effective against most available treatments for PsA in Sweden, irrespective of prior TNFi exposure.