Objectives: To describe patient characteristics and costs associated with first year biologic therapy use in psoriasis patients who switched or remained on biologic therapy. Methods: Adult patients with psoriasis diagnosis (ICD-9 CM 696.1 or 696.8 codes, excluding psoriatic arthritis (ICD-9-CM 696.0), rheumatoid arthritis(ICD-9-CM 714.x), ankylosing spondylitis(ICD-9-CM 720.0), Crohn's disease(ICD-9-CM 555.x) or ulcerative colitis(ICD-9-CM 556.x)) with continuous insurance coverage for one year pre and post first biological therapy prescription, having at least one prescription of adalimumab, etanercept, infliximab or ustekinumab and no previous use of biologic were selected from a privately insured MarketScan commercial and Medicare database, 2012 . Two patient cohorts of switchers and non-switchers were defined based on gap of 60 days of therapeutic benefit. Analyses included descriptive statistics and per member per year costs. Results: Of the 2848 patients who met the study criteria, 8.32% (n= 237) switched(S) to another biologic therapy, 1305 (45.82%) remained on initial biologic therapy (non-switched (NS)) and 1,306 (45.86%) discontinued their treatment within the first year of initiating biologic therapy. The mean age(SD) was 46.9(13.3) years with a higher percentage of males in the non-switched group than switched and discontinued groups (59.4% vs. 51.1% and 52.5%, respectively). One year post start of biologic therapy, total health care cost per patient (S: US$38,529(24,328), NS: US$32,822(15,913)), all cause hospitalization cost per patient (S: US$1713(12,528), NS: US$911(4663)) and all cause emergency room cost per patient (S: US$447 (1300), NS: US$266 (1000)) were higher among patients who switched to another biologic therapy than among patients who remained on their initial biologic therapy. Conclusions: Although few patients switched from their initial biologic therapy within first year of initiating treatment, higher direct health care costs were observed in this patient group compared to those who remained on their initial therapy. These results suggest an unmet need among patients that switch biologic therapies in psoriasis.
Qureshi, A., Mallya, U., Zhang, X., Li, L., & Lahoz, R. (2013). Direct Health Care Costs of Patients Switching Biologic Therapies in Chronic Plaque Psoriasis. Value in Health, 16(7), A727. https://doi.org/10.1016/j.jval.2013.08.2283