Based on CADTH’s reanalysis, tildrakizumab is not cost-effective at a WTP threshold of $50,000 per QALY; CADTH’s findings on the cost-effectiveness of tildrakizumab are aligned with the sponsor’s results. Some biologic drugs provide better efficacy in terms of response at a lower total cost (e.g., adalimumab, brodalumab, and infliximab have better efficacy than tildrakizumab at a lower total cost). At least a 20% reduction in the submitted price would be required for tildrakizumab to be cost-effective at a WTP threshold of $50,000 per QALY. It should be noted there is significant uncertainty around the clinical effectiveness of tildrakizumab; additionally, the economic model did not allow CADTH to assess the impact of assumptions relating to the waning of treatment effect and the use of alternative treatment sequences in clinical practice. This adds to the uncertainty of the cost-effectiveness of tildrakizumab.