Real-world switch patterns and healthcare costs in biologic-naive psoriasis patients initiating apremilast or biologics

J Comp Eff Res. 2020 Aug;9(11):767-779. doi: 10.2217/cer-2020-0045. Epub 2020 Jul 8.

Abstract

Aim: Treatment switching and healthcare costs were compared among biologic-naive psoriasis patients initiating apremilast or biologics with ≥12 months pre-/post-index continuous enrollment in Optum Clinformatics™ Data Mart. Methods: After propensity score matching, switch rates (new therapy post-index) and days between index and switch were assessed. Total and per-patient per-month costs by service type were assessed. Results: Apremilast initiators (n = 533) were matched and compared with biologic initiators (n = 955). Twelve-month cumulative switch rates and days to switch were similar. Apremilast initiators had significantly lower total healthcare costs than biologic initiators; apremilast switchers and nonswitchers had significantly lower per-patient per-month costs than biologic switchers and nonswitchers, driven mainly by reduced outpatient pharmacy costs. Conclusion: Apremilast initiators had lower healthcare costs even with treatment switching.

Keywords: apremilast; biologics; healthcare costs; switch rates; treatment adherence.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / economics
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Biological Products / economics
  • Biological Products / therapeutic use*
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Phosphodiesterase 4 Inhibitors / economics
  • Phosphodiesterase 4 Inhibitors / therapeutic use*
  • Propensity Score
  • Psoriasis / drug therapy*
  • Retrospective Studies
  • Thalidomide / analogs & derivatives*
  • Thalidomide / economics
  • Thalidomide / therapeutic use
  • Treatment Outcome
  • Treatment Switching

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Biological Products
  • Phosphodiesterase 4 Inhibitors
  • Thalidomide
  • apremilast