Switch rates and total cost associated with apremilast and biologics in biologic-naive patients with psoriatic arthritis

Abstract

Aim: Real-world treatment data for psoriatic arthritis are limited. We evaluated switch rates, adherence, and costs for patients initiating apremilast versus tumor necrosis factor inhibitor (TNFi) and interleukin inhibitor (ILi) among biologic-naive psoriatic arthritis patients. Materials & methods: This retrospective analysis used IBM MarketScan claims data to assess treatment switches, adherence and costs. Results: Twelve-month switch rates were significantly lower for apremilast versus TNFi (15.5% vs 26.6%; p < 0.0001) and similar to ILi (15.5% vs 14.0%; p = 0.71). Apremilast initiators had lower total costs versus TNFi and ILi (US$39,854 vs US$57,243 and US$65,687; p < 0.05) and adherence was slightly lower versus TNFi and higher versus ILi. Conclusion: Biologic-naive apremilast initiators had lower switch rates versus TNFi initiators and lower total costs versus TNFi or ILi initiators.

Drug Utilization and Measurement of Medication Adherence: A Real World Study of Psoriasis in Italy

“…Feldman’s study highlighted even lower persistence with anti-TNF agents, considering longer follow-up periods at 12, 18, and 24 months. The observed low persistence with apremilast is consistent with previous findings as described by Feldman SR and others [ 31 , 33 ]. These findings suggest multiple factors contributing to poor persistence, including potential drug inefficiency, loss of response over time, and the occurrence of adverse events [ 27 , 28 ].…”

“…These findings seem to align with previous literature, highlighting low rates of therapy switches [ 31 , 32 , 33 , 34 ]. Specifically, in the Italian context, Giometto et al (2022) reported a low overall switch rate (20%) with anti-IL drugs [ 30 ].…”

“…Recent clinical evidence has revealed that therapeutic swaps, specifically, can lead to additional improvements that may have a positive impact on patients’ quality of life. It is worth noting that much of the existing clinical evidence on medication changes primarily focuses on switches while overlooking the intricacies associated with therapeutic swaps [ 16 , 31 , 32 , 33 , 34 ]. Our dataset revealed that, overall, 93% of patients initiated the first prescribed therapy.…”