Background/Purpose: Dermatomyositis (DM) and polymyositis (PM) are rare autoimmune conditions primarily characterized by muscle weakness and inflammation. Real-world evidence on economic outcomes of patients with DM or PM who used oral corticosteroids (OCS) is limited. This study investigated the association between duration and dose of OCS and annual healthcare costs and resource utilization among patients with DM or PM.

Methods: Adults who had ≥2 medical claims of DM/PM, with 30-365 days apart between 1/1/2016 and 12/31/2022 and ≥1 diagnosis code associated with a physician specialty of interest (eg, rheumatologist) were selected from the IBM MarketScan^® databases. Patients were required to have ≥1 pharmacy claim for OCS on or after the diagnosis date (date of the first OCS claim was designated as index date); ≥12 months pre- and 12 months post-index continuous enrollment; and should not have a diagnosis of inclusion body myositis during the study period. Patients were classified as long-term (LT) users if they had continuous OCS use for ≥3 consecutive months (ie, no gaps >90 days from the dispensing date of previous prescription to the date of the next prescription or the end of data availability) within the 12-month post-index period; otherwise, they were classified as short-term (ST) users. Patients were classified into the medium/high-dose (MHD) group if they had an average daily dose >7.5 mg/day within the 12-month post-index period; otherwise, they were classified into the low-dose (LD) group.

Results: A total of 2280 patients (mean [±SD] age: 53 [±13.4] years; female: 74.6%) were included, of which 1313 (57.6%) were in the LT and 1592 (69.8%) in the MHD group. Compared with the ST or LD groups, LT or MHD OCS users had increased odds for all-cause inpatient admission (LT vs ST: adjusted odds ratio [aOR], 1.66; 95% CI, 1.28-2.15; MHD vs LD: aOR, 1.67; 95% CI, 1.27-2.20), and positive association with disease-related inpatient admission (LT vs ST: aOR, 3.78; 95% CI, 2.30-6.21; MHD vs LD: aOR, 2.07; 95% CI, 1.27-3.36) after baseline covariate adjustment. On average, LT users incurred higher adjusted total all-cause costs by $21,310 (p< 0.01), and higher adjusted disease-related costs by $18,334 (p< 0.01) compared with ST users. MHD users incurred higher adjusted total all-cause costs by $17,638 (p< 0.01) and higher adjusted disease-related costs $9562 (p=0.01) compared with LD users.

Conclusion: Patients with LT or MHD OCS incurred substantially higher economic burden. These findings provide insights to inform clinical care and support the development of advanced therapy that can reduce OCS use among patients with DM or PM.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/healthcare-costs-and-resource-utilization-associated-with-long-term-medium-to-high-dose-oral-corticosteroid-use-in-patients-with-dermatomyositis-or-polymyositis/