Healthcare Cost and Utilization Associated with Biologic Treatment Patterns Among Patients with Psoriatic Arthritis: Analyses from a Large US Claims Database

Hur, Peter; Kim, Nina; Dai, Dong; Piao, Olivia W; Zheng, Josh Z; Yi, Esther

doi:10.1007/s40801-020-00217-4

Cited by 6 publications

(3 citation statements)

References 37 publications

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“…Our findings are also consistent with a number of studies [11][12][13][27][28][29][30][31][32][33][34][35][36][37][38] conducted in varying settings, which have assessed health care costs associated with non-persistence in treatment with biologics in IA indications. While most of them evaluated costs only in RA, a few studies considered other IA indications either additionally [12] or exclusively [33,37]. Apart from the costs of the biologic therapies, persistence with biologics was consistently reported to be associated with cost offsets in HCRU compared to non-persistence.…”

Section: Discussionsupporting

confidence: 90%

“…In addition to costs of HCRU, Ziegelbauer and colleagues [13] found that non-persistence with SC-TNFis was associated with higher indirect costs in treatment for IA in a cohort of German patients. However, both that German study [13] and the most the other studies investigating this matter [11,12,28,[31][32][33][34][35][36][37][38] have evaluated costs associated with non-persistence using claims data, which due to selection bias may limit the generalizability to the general IA population. Our study utilizes population-based registers with good coverage, thus allowing for increased generalizability of our results.…”

Section: Discussionmentioning

confidence: 99%

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Health-Care and Societal Costs Associated with Non-Persistence with Subcutaneous TNF-α Inhibitors in the Treatment of Inflammatory Arthritis (IA): A Retrospective Observational Study

Dalén¹,

Chitkara

Svedbom³

et al. 2021

Adv Ther

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Objective A few studies have suggested that patients with inflammatory arthritis (IA) who remain persistent with subcutaneous TNF-α inhibitors (SC-TNFi) incur lower health care costs than patients who discontinue treatment, whereas data on the impact of non-persistence on indirect costs are largely lacking. Furthermore, existing estimates are based on fixed follow-ups, in relation to treatment initiation, and therefore do not measure costs in direct relation to treatment discontinuation. Therefore, by capturing costs in direct relation to treatment discontinuation, this study aimed to estimate direct and indirect costs associated with non-persistence with SC-TNFis in IA. Methods Adult Swedish biologic-naïve IA patients initiating biologic treatment with a SC-TNFi (adalimumab, etanercept, certolizumab or golimumab) between May 6, 2010, and December 31, 2017, were identified in population-based registers with almost complete coverage. IA was defined as a diagnosis of rheumatic arthritis, ankylosing spondylitis/unspecified spondyloarthritis or psoriatic arthritis. Non-persistent patients were matched on propensity score to patients persistent with treatment by at least an additional 12 months. This enabled comparisons of direct healthcare costs and indirect costs for sick leave and disability pension, respectively, 12 months before and 12 months after treatment discontinuation. Results A balanced cohort of 486 matched pairs was generated. The total direct and indirect costs were significantly higher among non-persistent patients already during the 12 months before index ($20,802 [18,335–23,429] vs. $16,600 [14,331–18,696]). However, while non-persistent patients increased their total direct and indirect costs, persistent patients significantly decreased the same, further widening the difference in costs during the 12-month period after index date ($22,161 [19,754–24,556] vs. $13,465 [11,415–15,729]). Conclusions Among biologic-naïve Swedish IA patients treated with SC-TNFis, persistent patients incurred about 40% lower aggregated direct and indirect costs compared to non-persistent patients the year following SC-TNFi discontinuation. This highlights the impact of treatment persistence from an economic viewpoint, adding further aspects to the clinical perspective. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01970-w.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Health-Care and Societal Costs Associated with Non-Persistence with Subcutaneous TNF-α Inhibitors in the Treatment of Inflammatory Arthritis (IA): A Retrospective Observational Study

Dalén¹,

Chitkara

Svedbom³

et al. 2021

Adv Ther

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“…Fortunately, many different systemic therapy options are available nowadays to treat psoriasis ( 12 , 13 ). Modern biologics have been shown to be highly effective; however, these medications are expensive and can place a high financial burden on the healthcare system, if frequently and irrationally prescribed ( 14 , 15 ). Fumaric acid esters (FAEs) remain an appropriate and much more cost-effective therapy option for patients with moderate to severe psoriasis ( 12 ).…”

mentioning

confidence: 99%

Discontinuation of Fumaric Acid Esters is Affected by Depressive Symptomatology: A Retrospective Analysis

Krefting,

Hölsken,

Schedlowski

et al. 2024

Acta Derm Venereol

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Fumaric acid esters (FAEs) remain a widespread therapy option for moderate-to-severe psoriasis. However, drug survival of FAEs is limited by adverse events (AEs) or inadequate treatment response. Depressive disturbances are highly prevalent in psoriasis patients and are hypothesized to be associated with the reporting of AEs and therapy discontinuation. This study’s aim was to analyze whether psoriasis patients with comorbid depressive symptomatology are more likely to discontinue treatment with FAEs due to AEs and/or inadequate treatment response. Data were retrospectively extracted from the records of patients starting therapy with FAEs in the Department of Dermatology, University Hospital Essen, Germany between 2017 and 2022, covering the first 52 weeks of treatment. Psoriasis severity and depressive symptomatology, as well as AEs and therapy discontinuation, were analyzed. Psoriasis patients (N = 95, 47.37% female) with depressive symptomatology (42.11%) were more likely to discontinue therapy due to patient-reported AEs, while the total number of reported AEs was not associated with depression. The results support the hypothesis that among psoriasis patients with depressive symptoms, the associated introspection and somatization may result in increased sensitivity for AEs and thus in quicker therapy discontinuation. In these patients, the occurrence of nocebo effects should be minimized, e.g. by special communication techniques.

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Cost and Cost Effectiveness of Treatments for Psoriatic Arthritis: An Updated Systematic Literature Review

Antonazzo,

Gribaudo,

La Vecchia

et al. 2024

PharmacoEconomics

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Healthcare Cost and Utilization Associated with Biologic Treatment Patterns Among Patients with Psoriatic Arthritis: Analyses from a Large US Claims Database

Cited by 6 publications

References 37 publications

Health-Care and Societal Costs Associated with Non-Persistence with Subcutaneous TNF-α Inhibitors in the Treatment of Inflammatory Arthritis (IA): A Retrospective Observational Study

Health-Care and Societal Costs Associated with Non-Persistence with Subcutaneous TNF-α Inhibitors in the Treatment of Inflammatory Arthritis (IA): A Retrospective Observational Study

Discontinuation of Fumaric Acid Esters is Affected by Depressive Symptomatology: A Retrospective Analysis

Cost and Cost Effectiveness of Treatments for Psoriatic Arthritis: An Updated Systematic Literature Review

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