The costliest patients with psoriasis have significantly higher prevalence of comorbidities, prescription fills, inpatient, and emergency utilization, but not biologic medication use or biologic costs, according to the results of a recent study by April W Armstrong MD, MPH, and colleagues.1
Patients with psoriasis often have a significantly higher prevalence of comorbidities, prescription fills, inpatient and emergency utilization. These are all drivers of increased health care costs, however, these patients are not necessarily impacted by biologic medication use or biologic costs. Psoriasis has traditionally been treated with topical corticosteroids, phototherapy, and systemic medications, such as corticosteroids, methotrexate, and biologics. Biologics incur significantly higher costs relative to other treatment options, and over one-third of patients treated with existing biologics experience dose escalation.
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To compare various cost levels over 3 years, researchers identified participants with psoriasis in a large US health plan between 2011 and 2013. Study participants were placed in 4 groups that were created by health care costs excluding biologics. The groups included: patients having top 10% of costs in all 3 years (Top), top 10% in 2 of 3 years (High), bottom 90% in 2 of 3 years (Medium), and bottom 90% in all 3 years (Bottom). Among each of these groups, the study researchers compared comorbidities, utilization, and costs.
Story continues on page 2
Of the 18,653 identified participants, 514 (3%), 805 (4%), 2,443 (13%), and 14,891 (80%) participants were assigned to the Top, High, Medium, and Bottom groups, respectively. A significant number of participants in the Top vs Bottom group had diabetes (31.1% vs 9.4%), cardiovascular disease (26.5% vs 4.3%), psoriatic arthritis (25.7% vs 10.7%), depression (27.8% vs 6.9%), and anxiety (22.0% vs 7.9%) in 2011 (all P<0.05). Further, participants in the Top group had more unique 2011 prescriptions (17.7 vs 6.6; P<0.001) than the Bottom group, but similar biologic use (22.4% vs 21.6%). A comparison of participants in the Bottom group to those in the Top group showed an increased likelihood of 2011 hospitalization (36.8% vs 2.6%; psoriasis-related: 11.1% vs 0.7%) or emergency visits (50.8% vs 20.8%; psoriasis-related: 3.9% vs 1.0%).
The cost findings showed that participants in the Top, High, Medium, and Bottom groups had mean 2011 total costs of $68,913, $40,575, $24,292, and $8815. The mean total costs contributed to 14%, 13%, 23%, and 51% of the overall costs, respectively. Notably, mean total costs increased 14%-18% over time for all groups, and although mean 2011 total costs for patients in the Top group were 7.8 times of those in the Bottom group, psoriasis-related costs were less disparate ($8716 vs $4541).
“No known studies have examined the characteristics of patients who are consistently the most costly over time; such information can help both physicians and payers make informed decisions in psoriasis management,” Dr Armstrong concluded.
—Julie Gould (Mazurkiewicz)
Reference
- Armstrong AW, Zhao Y, Herrera V, et al. J Drugs Dermatol. 2017;16(7):651-658.
The costliest patients with psoriasis have significantly higher prevalence of comorbidities, prescription fills, inpatient, and emergency utilization, but not biologic medication use or biologic costs, according to the results of a recent study by April W Armstrong MD, MPH, and colleagues.1
Patients with psoriasis often have a significantly higher prevalence of comorbidities, prescription fills, inpatient and emergency utilization. These are all drivers of increased health care costs, however, these patients are not necessarily impacted by biologic medication use or biologic costs. Psoriasis has traditionally been treated with topical corticosteroids, phototherapy, and systemic medications, such as corticosteroids, methotrexate, and biologics. Biologics incur significantly higher costs relative to other treatment options, and over one-third of patients treated with existing biologics experience dose escalation.
________________________________________________________________________
Related Content
Is This Eruption From Psoriasis Treatment?
Psoriasis May Itch as Intensely as Atopic Dermatitis
________________________________________________________________________
To compare various cost levels over 3 years, researchers identified participants with psoriasis in a large US health plan between 2011 and 2013. Study participants were placed in 4 groups that were created by health care costs excluding biologics. The groups included: patients having top 10% of costs in all 3 years (Top), top 10% in 2 of 3 years (High), bottom 90% in 2 of 3 years (Medium), and bottom 90% in all 3 years (Bottom). Among each of these groups, the study researchers compared comorbidities, utilization, and costs.
Story continues on page 2
Of the 18,653 identified participants, 514 (3%), 805 (4%), 2,443 (13%), and 14,891 (80%) participants were assigned to the Top, High, Medium, and Bottom groups, respectively. A significant number of participants in the Top vs Bottom group had diabetes (31.1% vs 9.4%), cardiovascular disease (26.5% vs 4.3%), psoriatic arthritis (25.7% vs 10.7%), depression (27.8% vs 6.9%), and anxiety (22.0% vs 7.9%) in 2011 (all P<0.05). Further, participants in the Top group had more unique 2011 prescriptions (17.7 vs 6.6; P<0.001) than the Bottom group, but similar biologic use (22.4% vs 21.6%). A comparison of participants in the Bottom group to those in the Top group showed an increased likelihood of 2011 hospitalization (36.8% vs 2.6%; psoriasis-related: 11.1% vs 0.7%) or emergency visits (50.8% vs 20.8%; psoriasis-related: 3.9% vs 1.0%).
The cost findings showed that participants in the Top, High, Medium, and Bottom groups had mean 2011 total costs of $68,913, $40,575, $24,292, and $8815. The mean total costs contributed to 14%, 13%, 23%, and 51% of the overall costs, respectively. Notably, mean total costs increased 14%-18% over time for all groups, and although mean 2011 total costs for patients in the Top group were 7.8 times of those in the Bottom group, psoriasis-related costs were less disparate ($8716 vs $4541).
“No known studies have examined the characteristics of patients who are consistently the most costly over time; such information can help both physicians and payers make informed decisions in psoriasis management,” Dr Armstrong concluded.
—Julie Gould (Mazurkiewicz)
Reference
- Armstrong AW, Zhao Y, Herrera V, et al. J Drugs Dermatol. 2017;16(7):651-658.
The costliest patients with psoriasis have significantly higher prevalence of comorbidities, prescription fills, inpatient, and emergency utilization, but not biologic medication use or biologic costs, according to the results of a recent study by April W Armstrong MD, MPH, and colleagues.1
Patients with psoriasis often have a significantly higher prevalence of comorbidities, prescription fills, inpatient and emergency utilization. These are all drivers of increased health care costs, however, these patients are not necessarily impacted by biologic medication use or biologic costs. Psoriasis has traditionally been treated with topical corticosteroids, phototherapy, and systemic medications, such as corticosteroids, methotrexate, and biologics. Biologics incur significantly higher costs relative to other treatment options, and over one-third of patients treated with existing biologics experience dose escalation.
________________________________________________________________________
Related Content
Is This Eruption From Psoriasis Treatment?
Psoriasis May Itch as Intensely as Atopic Dermatitis
________________________________________________________________________
To compare various cost levels over 3 years, researchers identified participants with psoriasis in a large US health plan between 2011 and 2013. Study participants were placed in 4 groups that were created by health care costs excluding biologics. The groups included: patients having top 10% of costs in all 3 years (Top), top 10% in 2 of 3 years (High), bottom 90% in 2 of 3 years (Medium), and bottom 90% in all 3 years (Bottom). Among each of these groups, the study researchers compared comorbidities, utilization, and costs.
Story continues on page 2
Of the 18,653 identified participants, 514 (3%), 805 (4%), 2,443 (13%), and 14,891 (80%) participants were assigned to the Top, High, Medium, and Bottom groups, respectively. A significant number of participants in the Top vs Bottom group had diabetes (31.1% vs 9.4%), cardiovascular disease (26.5% vs 4.3%), psoriatic arthritis (25.7% vs 10.7%), depression (27.8% vs 6.9%), and anxiety (22.0% vs 7.9%) in 2011 (all P<0.05). Further, participants in the Top group had more unique 2011 prescriptions (17.7 vs 6.6; P<0.001) than the Bottom group, but similar biologic use (22.4% vs 21.6%). A comparison of participants in the Bottom group to those in the Top group showed an increased likelihood of 2011 hospitalization (36.8% vs 2.6%; psoriasis-related: 11.1% vs 0.7%) or emergency visits (50.8% vs 20.8%; psoriasis-related: 3.9% vs 1.0%).
The cost findings showed that participants in the Top, High, Medium, and Bottom groups had mean 2011 total costs of $68,913, $40,575, $24,292, and $8815. The mean total costs contributed to 14%, 13%, 23%, and 51% of the overall costs, respectively. Notably, mean total costs increased 14%-18% over time for all groups, and although mean 2011 total costs for patients in the Top group were 7.8 times of those in the Bottom group, psoriasis-related costs were less disparate ($8716 vs $4541).
“No known studies have examined the characteristics of patients who are consistently the most costly over time; such information can help both physicians and payers make informed decisions in psoriasis management,” Dr Armstrong concluded.
—Julie Gould (Mazurkiewicz)
Reference
- Armstrong AW, Zhao Y, Herrera V, et al. J Drugs Dermatol. 2017;16(7):651-658.
