Session Type: Abstract Submissions (ACR)
Background/Purpose: Several treatment options are available for psoriatic arthritis (PsA) patients (pts). The healthcare cost associated with the management of PsA pts varies depending on the disease severity and treatments used by pts. Methotrexate (MTX) and biologics are commonly prescribed disease-modifying anti-rheumatic drugs (DMARDs) in PsA. Due to the safety concerns around these DMARDs, frequent monitoring is required during clinical practice. The objective of this study was to describe healthcare costs associated with the management of PsA in pts newly initiated on a biologic DMARD or on MTX, focusing on office care and monitoring costs.
Methods: Adult pts with ≥ 2 PsA diagnosis (from office visits) were selected from the MarketScan Commercial Claims database (2005-2009). The first biologic DMARD or MTX prescription date was defined as the index date. Biologic initiators were required to be biologic-naïve prior to the index date but may have used a non-biologic DMARD. MTX initiators were required to be both biologic and non-biologic DMARD naïve prior to index date. Pts with a diagnosis of ankylosing spondylitis prior to the index date were excluded. All patients were required to have continuous enrollment 6-month prior to and 12-month post index date. All-cause and PsA-related total healthcare costs were estimated during the 12-month study period from a payer perspective and expressed in 2011 USD. PsA-related medical costs were identified based on claims for medical services associated with a PsA diagnosis or costs associated with DMARD administration by healthcare professionals. Among medical costs, office care and monitoring costs were defined as the sum of costs for outpatient visits and other medical service costs (excluding costs for drugs administered by healthcare professionals) that were associated with a diagnosis of PsA. Urgent care cost was defined as the sum of costs for inpatient service and ER visits. PsA-related pharmacy costs were identified based on claims for a biologic or a non-biologic DMARD irrespective of a PsA diagnosis.
Results: A total of 1,217 MTX initiators and 3,263 biologic initiators met the eligibility criteria. Over the 12-month study period, MTX initiators had an average total healthcare cost of $14,329 and $6,065 were PsA-related. Pharmacy costs accounted for 80.4% ($4,878) of the PsA-related total costs; office care and monitoring costs ($986) accounted for 16.3%; urgent care costs accounted for 3.3% ($201). Biologic initiators had an average annual total healthcare cost of $30,282 and 67.5% were PsA-related ($20,439). Pharmacy costs accounted for 92.7% ($18,938) of the PsA-related total costs; office care and monitoring cost ($1,041) accounted for 5.1%; urgent care cost ($461) accounted for 2.2%.
Conclusion: PsA patients initiating on a DMARD are associated with substantial healthcare costs. Although pharmacy costs accounted for the majority of the PsA-related costs, office care and monitoring costs accounted for a significant part of the PsA-related costs.
J. R. Curtis,
Celgene, Roche/Genetech, UCB< Centocor, Corrona,Amgen, Pfizer, BMS, Crescendo, Abbott, 2, Celgene, Roche/Genetech, UCB< Centocor, Corrona,Amgen, Pfizer, BMS, Crescendo, Abbott, 5.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/healthcare-costs-in-psoriatic-arthritis-patients-newly-initiated-on-a-biologic-disease-modifying-anti-rheumatic-drug-or-methotrexate/