A British cost-effectiveness analysis that considered adult patients with active psoriatic arthritis who were naïve to TNF-α inhibitors, without concomitant moderate-to-severe psoriasis and who had responded inadequately to csDMARDs, found that secukinumab was associated with higher total costs but a greater number of quality-adjusted life years (QALYs) over the 40-year model time horizon compared to adalimumab, resulting in an ICER (incremental cost-effectiveness ratio) of £5680 per QALY gained for secukinumab versus adalimumab [20]. This evidence concerns the gene TNF and psoriatic arthritis.