A new economic evaluation published in JAMA Dermatology has found that adalimumab 40 mg administered weekly offers the most consistent balance between treatment effectiveness and cost among currently approved monoclonal antibody therapies for hidradenitis suppurativa (HS).
The analysis compared the cost-efficiency of three biologic therapies—adalimumab, secukinumab and bimekizumab—using phase 3 clinical trial data and drug pricing information from the United States, Canada, France, Germany and Australia. The study was published online on August 5, 2026.
Adalimumab consistently remained on the efficiency frontier
Researchers assessed the therapies using two commonly used measures of treatment response in HS: HiSCR-50, representing at least a 50% reduction in inflammatory lesion counts, and HiSCR-75, representing a 75% reduction.
Adalimumab remained on the efficiency frontier for both outcomes across all five countries examined. In economic terms, this means it provided a more favorable combination of clinical benefit and treatment cost than the alternatives under most of the pricing scenarios evaluated.
Secukinumab appeared on the efficiency frontier only under the US wholesale acquisition cost scenario. The researchers also found that adjusting the analysis for differences in baseline disease severity did not substantially change the overall findings.
Large differences in treatment costs
One of the striking findings was the wide variation in annual treatment costs between medicines and countries.
The estimated annual cost ranged from approximately 11,345 USD for weekly adalimumab in Australia to as high as $411,990 for bimekizumab administered every two weeks in the United States.
The findings illustrate how drug pricing can substantially influence the economic value of biologic therapies, even when medicines are being evaluated for the same disease.
Why the findings matter for HS treatment
Hidradenitis suppurativa is a chronic inflammatory skin disease that can significantly affect quality of life. Biologic therapies have expanded treatment options for patients with moderate to severe disease, but their high costs remain an important consideration for healthcare systems and payers.
The researchers said their findings could provide a framework for value-based pricing and healthcare decision-making in HS. The analysis also highlights that the most clinically effective option is not necessarily the most economically efficient option once treatment costs are considered.
The study was conducted using publicly available clinical trial and pricing data, with pricing information collected as of January 31, 2026. The authors noted that international differences in biologic pricing can have a substantial effect on cost-efficiency assessments.
Study publication
The study, “Approved Monoclonal Antibody Therapies for Hidradenitis Suppurativa,” was authored by James Pham, Tara Sholji, Marra Aghajani, Cindy Kok and John W. Frew and published in JAMA Dermatology.
