Above-label Use is Most Frequent Among Patients With Psoriasis Receiving Etanercept and Ixekizumab, Resulting in Higher Costs but Few Safety Concerns
Patients with psoriasis receiving etanercept, followed by ixekizumab, adalimumab, and secukinumab had more frequent above-label use of biologics for treatment, which resulted in additional costs but few safety concerns, according to a recent study in the Journal of Medical Economics.
“The objectives of this study are to document real-world dose-escalation patterns in patients with psoriasis, examine additional costs associated with above-label use of biologics, and assess the safety of above-label use of these biologics,” stated the study authors.
Researchers performed a descriptive, retrospective cohort analysis using the IBM MarketScan Commercial and Medicare Supplemental Databases to evaluate adult patients diagnosed with plaque psoriasis. Patients eligible for the study were initiating treatment with etanercept, adalimumab, ixekizumab, or secukinumab between January 1, 2015, and November 30, 2019. Outcomes measured included the percentage of patients with above-label use, time to dose escalation, number of days of above-label use, and additional costs associated with above-label use.
The percentage of patients with above-label use was 46% of patients receiving etanercept, 11% receiving adalimumab, 17.5% receiving ixekizumab, and 9.2% receiving secukinumab. Mean time to above-label use for all treatments was 21 to 37 days with a median of 35 to 175 days. Medical/pharmacy costs associated with above-label use were an additional mean total of $312/$16,475 for etanercept, $278/$9,773 for adalimumab, $124/$5,202 for ixekizumab, and $277/$9,288 for secukinumab. Safety concerns were not associated with above-label use, but gastrointestinal and other nonrespiratory infections were more frequent in patients receiving adalimumab above-label.
“Above-label use of biologics for psoriasis treatment was most frequent for patients receiving etanercept, followed by ixekizumab, adalimumab, and secukinumab,” concluded the study authors. “Above-label vs on-label use resulted in additional costs but few significant safety concerns.”
Reference
Bagel J, Glick B, Wu JJ, et al. Dose escalation and associated costs in biologic treatment of psoriasis based on real-world data. J Med Econ. 2021;24(1):782-791. doi:10.1080/13696998.2021.1937187
