Budget impact analysis of delgocitinib for moderate to severe Chronic Hand Eczema in the United States

BACKGROUND: Chronic Hand Eczema (CHE) is an inflammatory skin disease defined as eczema affecting the hands and/or wrists lasting >3 months and/or re-occurring ≥2 times per year. Delgocitinib cream 20 mg/g, a topical janus kinase inhibitor (JAKi), is approved in multiple countries for the treatment of moderate to severe CHE in adults who have had an inadequate response to topical corticosteroids (TCS) or for whom TCS are inadvisable. This budget impact analysis aimed to estimate the economic impact of the introduction of delgocitinib cream as a treatment for moderate to severe CHE in the United States (US). METHODOLOGY: The model was developed with a 3-year time horizon from the perspective of a hypothetical US commercial healthcare plan involving one million members. Comparator treatments included other topical and oral JAKis and biologics. Proportions of patients using each treatment were accounted for in calculating healthcare costs. The eligible population with moderate to severe CHE refractory to steroids was estimated considering prevalent and incident populations. Different healthcare costs, including drug, monitoring, and adverse event (AE) costs, were accounted for. AEs were included based on clinical trial data. Costs were adjusted to 2024. RESULTS: Of one million members overall, the study population included 10,494, 11,095, and 11,696 patients with CHE in Years 1, 2 and 3, respectively. The introduction of delgocitinib cream was associated with overall cost savings of $2,973,478 in Year 1, $21,424,214 in Year 2, and $63,355,366 in Year 3, constituting total accumulated savings of $87,753,057. Savings were derived almost entirely from drug costs (97.2%), with reduced AE (1.54%) and monitoring costs (1.27%) also contributing. CONCLUSION: Adoption of delgocitinib cream for moderate to severe CHE in adults for whom TCS were inadequate or inadvisable is predicted to generate significant cost savings to US commercial healthcare plans over 3 years.