Tratamiento de la psoriasis en placas moderada a grave con fármacos biológicos: análisis del sobrecoste de la intensificación temporal frente a cambio a otro biológico en caso de fracaso secundario

Puig, Lluís

doi:10.1016/j.ad.2013.10.014

Cited by 19 publications

(10 citation statements)

References 13 publications

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“…When dealing with a lack of treatment response, it is important to understand and consider the cost implications of off-label utilization in the real-world setting [8]. The current study is the first to provide an estimated total annual all-cause healthcare cost of $55,349 (etanercept), $54,176 (adalimumab), and $47,993 (golimumab) US dollars for above-label use (≥180 days) in PsA.…”

Section: Discussionmentioning

confidence: 99%

“…A lack of PsA symptom control with initial bDMARD use has been reported to influence decisions to change medications or request additional treatment options [1, 3–7]. Traditionally in a non-responder, a physician may switch the patient from one bDMARD to another bDMARD or change the dose of the therapy being utilized [3–8]. Treat-to-target strategies are also being recommended as a patient-centric approach for managing PsA.…”

Section: Introductionmentioning

confidence: 99%

“…Limited research has been conducted to support long-term health outcomes associated with patterns of bDMARD utilization in the symptom management of PsA [3, 4, 12, 15, 16]. Off-label dosages (i.e., dose escalation or reduction, interrupted treatment) have been shown to occur in clinical practice for the treatment of other inflammatory conditions, such as psoriasis (PsO) and rheumatoid arthritis (RA) [8, 13, 17–20]. Studies have demonstrated that dose escalation with bDMARDs commonly occurs for patients with RA and results in increased cost [13, 18–22].…”

Section: Introductionmentioning

confidence: 99%

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Economic impact of biologic utilization patterns in patients with psoriatic arthritis

Schwartzman

Zhou

et al. 2017

Clin Rheumatol

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The aim of the study is to examine the frequency and costs associated with above-label dosing of biologics in patients with psoriatic arthritis (PsA). MarketScan identified adults with ≥1 International Classification of Diseases, Clinical Modification diagnosis for PsA and ≥1 pharmacy claim for biologics of interest between January 1, 2011 and December 31, 2013. The first biologic claim was the index date with a 1-year follow-up period and three additional months to confirm continuous biologic use. Exclusion criteria included switching to a different biologic or diagnosis with another autoimmune disease. During the follow-up period, duration was stratified into three groups: <30, 30–179, and ≥180 days of above-label dosing (>10% of the labeled dose). One-tailed t test was conducted to examine the impact of above-label duration on healthcare costs. We identified 4245 PsA patients receiving etanercept (n = 2342), adalimumab (n = 1788), and golimumab (n = 115). Above-label dosing of <30 days (85% adalimumab, 90.4% etanercept, and 95.7% golimumab) and ≥180 days (9.6% adalimumab, 4.1% etanercept, and 2.6% golimumab) was observed. All-cause total healthcare costs for <30 days of above-label use (etanercept $30,625, adalimumab $31,620, and golimumab $37,224), 30–179 days (etanercept $35,602, adalimumab $38,915, and golimumab $64,349), and ≥180 days (etanercept $55,349, adalimumab $54,176, and golimumab $47,993) were reported. Longer above-label duration (30–179 versus <30 days, ≥180 versus 30–179 and ≥180 days) with etanercept or adalimumab was significantly associated with higher mean increased total all-cause healthcare, PsA-specific healthcare, and biologic costs (p < 0.05). Above-label use of anti-TNF biologics does occur and is associated with significantly increased healthcare costs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Economic impact of biologic utilization patterns in patients with psoriatic arthritis

Schwartzman

Zhou

et al. 2017

Clin Rheumatol

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“… 41 , 42 Therapeutic intensification, although it allows avoiding secondary inefficacy, entails additional costs and, moreover, the safety of increased exposure to immunosuppressive agents is not clearly studied. 43 In addition, the use of multiple cycles of therapeutic intensification was associated with lower efficacy, with lower reductions of PASI in a second intensification cycle when compared with reduction of PASI obtained in the first cycle. 28 …”

Section: Psoriasis Treatmentmentioning

confidence: 99%

Moderate to severe psoriasis treatment challenges through the era of biological drugs

Vide

Magina

2017

An. Bras. Dermatol.

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Biological therapy has revolutionized moderate to severe psoriasis treatment. However, despite being more effective than conventional systemic treatments, some patients do not respond or lose response to biotechnological treatments or develop drug-antibodies, interfering with its safety and efficacy. There are also clinical forms of the disease and patient profiles for which is pending further scientific evidence for more sustained therapeutic interventions. The continuous and more detailed knowledge of psoriasis pathophysiology has allowed identifying new therapeutic targets, which is expected to help overcome the challenges of individualized psoriasis treatment.

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“… 18 Satisfaction, adherence, and outcomes can vary based upon a patient’s prior experience with treatments; 10 , 15 , 19 switching therapies or increasing the frequency of dosing has been a common approach to inadequate outcomes. 20 – 22 Because of these recent findings, interest is growing in patient-centered approaches to psoriasis treatment, ie, individualized options that incorporate patient preferences. 16 , 23 , 24 Furthermore, data are scarce on how patient choice of dosing frequency and treatment satisfaction depend on prior experience with biologics.…”

Section: Introductionmentioning

confidence: 99%

Patient-reported treatment satisfaction and choice of dosing frequency with biologic treatment for moderate to severe plaque psoriasis

Zhang¹,

Brenneman²,

Carter³

et al. 2015

PPA

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BackgroundModerate to severe plaque psoriasis has a serious effect on health-related quality of life. Patients treated with biologic medications place importance on satisfaction and treatment frequency options. We assessed patient-reported treatment satisfaction and dosing frequency choice with biologics.MethodsWe used a health care claims database to identify patients with moderate to severe plaque psoriasis. Participants completed the Treatment Satisfaction Questionnaire for Medication. Results were compared between patients experienced with biologics (adalimumab, etanercept, or ustekinumab) or not (cyclosporine or methotrexate). Participants were asked for their choices of dosing options of once every 1–2 weeks, 3–4 weeks, 1–2 months, or 2–3 months. Participants were also asked for their choices of dosing options of every 1, 2, 3, and so on up to every 12+ weeks.ResultsA total of 426 patients completed the survey (263 biologic-experienced and 163 biologic-naïve patients). Patient satisfaction with psoriasis treatment was significantly higher in the biologic-experienced cohort. The most frequently chosen option (38.8% of all participating patients) was every 2–3 months; 37.3% chose once every 1–2 weeks. Significant differences were found in the percentage of biologic-naïve patients choosing 2–3-month (49.7%) over 1–2-week (20.9%) dosing (P<0.001). Among biologic-experienced patients, the difference between the percentage of patients choosing the 2–3-month (35.7%) and 1–2-week (41.8%) options was not significant (P=0.264). The two most often week-specific intervals chosen by biologic-naïve patients were 12+ weeks (42.3%) and 4 weeks (15.6%). The biologic-experienced patients most often chose 12+ weeks (31.2%) and 1 week (25.9%).ConclusionPatients using biologics reported satisfaction with their treatment, which may positively affect outcomes. Longer dosing intervals were chosen most frequently among all patients combined. Reports of patient satisfaction with prior treatments and choices regarding dosing frequency, among all other considerations, should be evaluated in determining an appropriate biologic medication for psoriasis.

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Tratamiento de la psoriasis en placas moderada a grave con fármacos biológicos: análisis del sobrecoste de la intensificación temporal frente a cambio a otro biológico en caso de fracaso secundario

Cited by 19 publications

References 13 publications

Economic impact of biologic utilization patterns in patients with psoriatic arthritis

Economic impact of biologic utilization patterns in patients with psoriatic arthritis

Moderate to severe psoriasis treatment challenges through the era of biological drugs

Patient-reported treatment satisfaction and choice of dosing frequency with biologic treatment for moderate to severe plaque psoriasis

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Tratamiento de la psoriasis en placas moderada a grave con fármacos biológicos: análisis del sobrecoste de la intensificación temporal frente a cambio a otro biológico en caso de fracaso secundario

Cited by 19 publications

References 13 publications

Economic impact of biologic utilization patterns in patients with psoriatic arthritis

Economic impact of biologic utilization patterns in patients with psoriatic arthritis

Moderate to severe psoriasis treatment challenges through the era of biological drugs

Patient-reported treatment satisfaction&nbsp;and&nbsp;choice of dosing frequency&nbsp;with biologic treatment for&nbsp;moderate to severe plaque&nbsp;psoriasis

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Patient-reported treatment satisfaction and choice of dosing frequency with biologic treatment for moderate to severe plaque psoriasis