Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Psoriasis (PsO) and psoriatic arthritis (PsA) are associated with substantial economic and comorbidity burdens. However, the burden among PsO patients comorbid with PsA has not been evaluated in the biologics era. This study aimed to compare the comorbidity burden, healthcare resource utilization, and costs between moderate-to-severe PsO patients comorbid with PsA and matched controls.
Methods: Adults (18-64 years) with ≥2 distinct PsO diagnoses (ICD-9-CM: 696.1) were identified in the OptumHealth Reporting and Insights claims database (01/2007-03/2012). Moderate-to-severe PsO patients were selected as those receiving ≥1 systemic or phototherapy during the 12-month study period following the index date (randomly selected date after the first PsO diagnosis); PsO patients comorbid with PsA (PsO+PsA cases) were further selected as those with ≥2 distinct PsA diagnoses (ICD-9-CM: 696.0) between 01/2007 and the index date or during the 12-month study period. Controls were free of PsO and PsA in the entire claims history and matched 1: 1 with PsO+PsA cases on age, gender, and geographic region. All patients had at least 12 months of continuous enrollment after the index date. Multivariate regression models were performed to examine the impact of PsO+PsA on comorbidities, medication use, and healthcare utilization and costs between cases and controls, adjusting for demographics, index year, insurance type, non-PsO/PsA related comorbidities. Adjusted cost differences between cases and controls were also estimated.
Results: A total of 1,230 matched pairs of PsO+PsA patients and controls were selected, with mean age 48.5 years and 52.1% of male. During the 12-month period, PsO+PsA patients had significantly higher disease burden in major PsO/PsA related comorbidities assessed than controls, with the top 4 most common being hypertension (35.8% vs. 23.5%), hyperlipidemia (34.6% vs. 28.5%), rheumatoid arthritis (16.6% vs. 0.7%) and diabetes (15.9% vs. 10.0%). Controlling for between-group differences, PsO+PsA patients had more number of prescription medications filled (IRR=2.3), and were more likely to have any inpatient admission (OR=1.6), emergency department (OR=1.3), and outpatient visit (OR=62.7) compared with controls (all p<0.05). Additionally, PsO+PsA patients incurred significantly higher total, pharmacy, and medical costs (adjusted annual costs differences: $23,160, $17,696 and $5,077 per patient, respectively, all p<0.01) than controls.
Conclusion: Compared with matched controls without PsO and PsA, moderate-to-severe PsO patients comorbid with PsA were more likely to have PsO/PsA-related comorbidities and incurred significantly higher healthcare utilization and costs.
Disclosure:
S. R. Feldman,
Causa Technologies, Medical Quality Enhancement Corp.,
1,
Causa Technologies,
4,
Doak, Pfizer Inc., Pharmaderm, and SkinMedica, Inc.,
9,
Abbott Labs, Amgen, Astellas, Centocor Ortho Biotech Inc., Dermatology Foundation, Galderma, Leo Pharma Inc., Pharmaderm, Sanofi-Aventis, Stiefel/GSK, and Taro,
8,
Abbott Labs, Amgen, Astellas, Caremark, Celgene, Coria Laboratories, Galderma, Gerson Lehrman Group, Hanall Pharmaceutical Co. Ltd., Kikaku, Leo Pharma Inc., Medicis Pharmaceutical Corporation, Medscape, Merck & Co., Inc., Merz Pharmaceuticals, Novan,
5,
Novartis Pharmarceutical Corporation, Peplin Inc., Pfizer Inc., Photomedex, Reader’s Digest, Stiefel/GSK, Suncare Research, and US Department of Justice,
5,
Abbott Labs, Amgen, Anacor Pharmaceuticals Inc., Astellas, Celgene, Centocor Ortho Biotech Inc., Galderma, Medicis Pharmaceutical Corporation, SkinMedica Inc., and Stiefel/GSK,
2,
Informa Healthcare and Xlibris,
7,
Acuderm, Advanced Tissue Sciences, Allergan, Aventis, Bristol-Myers Squibb, Combe, Curatek, Ferndale, Fujisawa, Hermal, Hoffman LaRoche, Galderma, Genderm, Glaxo Wellcome, Hill, Janssen, Mayrand, NeoStrata, Neutrogena, Novartis, Oclassen, Ortho,
9,
Person & Covey, Proctor & Gamble, RJR Nabisco, Schering-Plough, Shelton, SmithKline, Stiefel, 3M, United Catalyst, Upjohn and Wolff Systems,
9;
Y. Zhao,
Novartis Pharmaceuticals Corporation,
3;
L. Shi,
Novartis Pharmaceuticals Corporation,
5;
J. Lu,
Novartis Pharmaceuticals Corporation,
9;
M. Tran,
Novartis Pharmaceuticals Corporation,
3.
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