{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T21:04:55Z","timestamp":1781211895191,"version":"3.54.1"},"reference-count":24,"publisher":"The Journal of Health Economics and Outcomes Research","issue":"1","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["jheor.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ritlecitinib, a JAK3\/TEC family kinase inhibitor, and baricitinib, a JAK1\/2 inhibitor, are approved for treating severe alopecia areata (AA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Develop a cost-per-responder analysis for ritlecitinib and baricitinib for treating severe AA to estimate the budget impact based on clinical efficacy, available dosages, and pricing structure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A decision tree evaluated cost implications of once-daily ritlecitinib 50 mg, or baricitinib 2 mg and 4 mg treatment over 1 year from a US perspective. Drug costs were estimated using wholesale acquisition costs. Distribution across treatment and dosing options were based on real-world evidence. We defined shorter-term response as Severity of Alopecia Tool (SALT) score relative change from baseline \u226530% (SALT \u0394\u226530%; SALT\n                      <jats:sub>30<\/jats:sub>\n                      ) at Weeks 18 and 24, and longer-term response as absolute SALT score \u226420 at Weeks 36 and 52. Patients initiating baricitinib 2 mg with no shorter-term response could uptitrate to 4 mg or discontinue therapy. Decision probabilities were derived from real-world evidence and clinical trial data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At Week 24, 52.10% of ritlecitinib initiators and 36.28% of baricitinib initiators achieved SALT \u0394 \u226530%; at Week 52, 40.26% and 30.63% of ritlecitinib and baricitinib initiators, respectively, achieved SALT \u226420. Baricitinib had a higher cost per responder than ritlecitinib at Weeks 24 ($54\u2009887 vs $45\u2009577) and 52 ($107\u2009217 vs $94\u2009834). Cost-equivalence was reached at Week 52 ($38\u2009180), with 42.72% of baricitinib patients initiating 2 mg treatment. Sensitivity analyses showed ritlecitinib cost per responder was lower at Week 24 (difference, \u2212$1532) and higher at Week 52 (difference, $10\u2009728) than only baricitinib 2 mg use, and lower at Weeks 24 and 52 (difference, \u2212$20\u2009001 and \u2212$60\u2009073) than only baricitinib 4 mg use. The lower cost per responder for ritlecitinib 50 mg vs baricitinib 2 or 4 mg at Weeks 24 and 52, and greater early efficacy and fewer discontinuations is consistent with the results of a prior indirect treatment comparison that supported favorable outcomes with ritlecitinib 50 mg vs baricitinib 2 mg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ritlecitinib 50 mg demonstrated a lower cost per responder than baricitinib 2 or 4 mg at Weeks 24 and 52, which may inform reimbursement or formulary inclusion of ritlecitinib for treating AA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.36469\/001c.159914","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T20:11:23Z","timestamp":1781208683000},"update-policy":"https:\/\/doi.org\/10.36469\/00001","source":"Crossref","is-referenced-by-count":0,"title":["A Cost-per-Responder Analysis of Ritlecitinib vs Baricitinib in Severe Alopecia Areata"],"prefix":"10.36469","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8484-6251","authenticated-orcid":false,"given":"Ashley S.","family":"Cha-Silva","sequence":"first","affiliation":[{"name":"Pfizer, Inc., New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate H.","family":"Zhang","sequence":"additional","affiliation":[{"name":"RTI Health Solutions, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher N.","family":"Graham","sequence":"additional","affiliation":[{"name":"RTI Health Solutions, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha K.","family":"Kurosky","sequence":"additional","affiliation":[{"name":"Pfizer, Inc., New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Tran","sequence":"additional","affiliation":[{"name":"Pfizer, Inc., New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest H.","family":"Law","sequence":"additional","affiliation":[{"name":"Pfizer, Inc., New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eingun J.","family":"Song","sequence":"additional","affiliation":[{"name":"Frontier Dermatology, Mill Creek, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22273","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref1","article-title":"Litfulo (ritlecitinib) [prescribing information]","author":"Pfizer","year":"2023","journal-title":"Pfizer"},{"key":"ref2","article-title":"Olumiant (baricitinib) [prescribing information]","author":"Eli Lilly & Co."},{"key":"ref3","article-title":"LEQSELVI\u2122 (deuruxolitinib) [prescribing information]","author":"Sun Pharmaceutical Industries Ltd."},{"issue":"10387","key":"ref4","doi-asserted-by":"publisher","first-page":"1518","DOI":"10.1016\/S0140-6736(23)00222-2","article-title":"Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata: a randomised, double-blind, multicentre, phase 2b-3 trial","volume":"401","author":"B. King","year":"2023","journal-title":"Lancet"},{"issue":"18","key":"ref5","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1056\/NEJMoa2110343","article-title":"Two phase 3 trials of baricitinib for alopecia areata","volume":"386","author":"B. King","year":"2022","journal-title":"N Engl J Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40257-023-00764-w","article-title":"Efficacy and safety of baricitinib in patients with severe alopecia areata over 52 weeks of continuous therapy in two phase III trials (BRAVE-AA1 and BRAVE-AA2)","author":"O. Kwon","year":"2023","journal-title":"Am J Clin Dermatol"},{"key":"ref7","article-title":"Merative Micromedex\u00ae Red Book\u00ae 2024","author":"Merative"},{"key":"ref8","article-title":"Data from: Data on file. OMNY_AA database analysis for Jan 2000\u2013July 2023. Percentage of patients initiating treatment with baricitinib 2 mg and up-titrating to 4 mg. 2023.","author":"Pfizer Inc.","year":"2023"},{"issue":"6","key":"ref9","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1093\/bjd\/ljad253","article-title":"When to expect scalp hair regrowth during treatment of severe alopecia areata with baricitinib: insights from trajectories analyses of patients enrolled in two phase III trials","volume":"189","author":"B. King","year":"2023","journal-title":"Br J Dermatol"},{"key":"ref10","article-title":"TechDig, Version 2.0d","year":"1998"},{"issue":"2","key":"ref11","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.autrev.2014.10.014","article-title":"The autoimmune basis of alopecia areata: a comprehensive review","volume":"14","author":"N. Islam","year":"2015","journal-title":"Autoimmun Rev"},{"key":"ref12","article-title":"Data from: Data on file. Week 48 absolute SALT score given week 18 relative improvement from baseline: 50 mg QD. 2024.","author":"Pfizer Inc.","year":"2024"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.20372","article-title":"Systematic review and indirect treatment comparisons of ritlecitinib against baricitinib in alopecia areata","author":"D. Aceituno","year":"2024","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"4","key":"ref14","doi-asserted-by":"publisher","first-page":"426","DOI":"10.18553\/jmcp.2022.28.4.426","article-title":"All-cause health care resource utilization and costs among adults with alopecia areata: a retrospective claims database study in the United States","volume":"28","author":"A. Mostaghimi","year":"2022","journal-title":"J Manag Care Spec Pharm"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1007\/s13555-022-00710-4","article-title":"Economic burden and healthcare resource use of alopecia areata in an insured population in the USA","volume":"12","author":"A. Mostaghimi","year":"2022","journal-title":"Dermatol Ther"},{"issue":"2","key":"ref16","doi-asserted-by":"publisher","first-page":"11","DOI":"10.36469\/001c.36229","article-title":"Healthcare utilization and costs among US adolescents with alopecia areata","volume":"9","author":"M. Ray","year":"2022","journal-title":"J Health Econ Outcomes Res"},{"issue":"3","key":"ref17","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.jaad.2019.08.032","article-title":"Epidemiology of alopecia areata, ophiasis, totalis, and universalis: a systematic review and meta-analysis","volume":"82","author":"H. H. Lee","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"259","DOI":"10.2147\/CCID.S245649","article-title":"A large cross-sectional survey study of the prevalence of alopecia areata in the United States","volume":"13","author":"M. Benigno","year":"2020","journal-title":"Clin Cosmet Investig Dermatol"},{"issue":"11","key":"ref19","doi-asserted-by":"publisher","first-page":"1967","DOI":"10.1111\/jdv.14959","article-title":"Sex- and age-adjusted prevalence estimates of five chronic inflammatory skin diseases in France: results of the \u00abOBJECTIFS PEAU\u00bb study","volume":"32","author":"M.-A. Richard","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"2","key":"ref20","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1111\/bjd.20628","article-title":"The epidemiology of alopecia areata: a population-based cohort study in UK primary care","volume":"186","author":"M. Harries","year":"2022","journal-title":"Br J Dermatol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"17011","DOI":"10.1038\/nrdp.2017.11","article-title":"Alopecia areata","volume":"3","author":"C. H. Pratt","year":"2017","journal-title":"Nat Rev Dis Primers"},{"issue":"2","key":"ref22","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1111\/ajd.12941","article-title":"Treatment of alopecia areata: an Australian expert consensus statement","volume":"60","author":"W. C. Cranwell","year":"2019","journal-title":"Australas J Dermatol"},{"issue":"4","key":"ref23","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1016\/j.jaad.2016.04.035","article-title":"Health-related quality of life (HRQoL) among patients with alopecia areata (AA): a systematic review","volume":"75","author":"L. Y. 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