Al Sawah Sarah, Foster Shonda A, Goldblum Orin M, Malatestinic William N, Zhu Baojin, Shi Nianwen, Song Xue, Feldman Steven R
a Eli Lilly and Company , Indianapolis , IN , USA.
b Truven Health Analytics, an IBM Company , Cambridge , MA , USA.
J Med Econ. 2017 Sep;20(9):982-990. doi: 10.1080/13696998.2017.1345749. Epub 2017 Jul 11.
To quantify healthcare costs in patients with psoriasis overall and in psoriasis patient sub-groups, by level of disease severity, presence or absence of psoriatic arthritis, or use of biologics.
Administrative data from Truven Health Analytics MarketScan Research Database were used to select adult patients with psoriasis from January 2009 to January 2014. The first psoriasis diagnosis was set as the index date. Patients were required to have ≥6 months of continuous enrollment with medical and pharmacy benefits pre-index and ≥12 months post-index. Patients were followed from index until the earliest of loss to follow-up or study end. All-cause healthcare costs and outpatient pharmacy costs were calculated for the overall psoriasis cohort and for the six different psoriasis patient sub-groups: (a) patients with moderate-to-severe disease and mild disease, (b) patients with psoriatic arthritis and those without, and (c) patients on biologics and those who are not. Costs are presented per-patient-per-year (PPPY) and by years 1, 2, 3, 4, and 5 of follow-up, expressed in 2014 US dollars.
A total of 108,790 psoriasis patients were selected, with a mean age of 46.0 years (52.7% females). Average follow-up was 962 days. All-cause healthcare costs were $12,523 PPPY. Outpatient pharmacy costs accounted for 38.6% of total costs. All-cause healthcare costs were highest for patients on biologics ($29,832), then for patients with psoriatic arthritis ($23,427) and those with moderate-to-severe disease ($21,481). Overall, all-cause healthcare costs and outpatient pharmacy costs presented an upward trend over a 5-year period.
Psoriasis is associated with significant economic burden, which increases over time as the disease progresses. Patients with moderate-to-severe psoriasis, those with psoriatic arthritis, or use of biologics contributes to higher healthcare costs. Psoriasis-related pharmacy expenditure is the largest driver of healthcare costs in patients with psoriasis.
按疾病严重程度、是否存在银屑病关节炎或是否使用生物制剂,对银屑病患者总体及银屑病患者亚组的医疗保健费用进行量化。
使用来自Truven Health Analytics MarketScan研究数据库的管理数据,选取2009年1月至2014年1月期间的成年银屑病患者。将首次银屑病诊断设定为索引日期。患者在索引前需有≥6个月的连续参保且享有医疗和药房福利,索引后需≥12个月。对患者从索引日期开始随访,直至最早出现失访或研究结束。计算了银屑病总体队列以及六个不同银屑病患者亚组的全因医疗保健费用和门诊药房费用:(a)中重度疾病和轻度疾病患者;(b)患有银屑病关节炎和未患银屑病关节炎的患者;(c)使用生物制剂和未使用生物制剂的患者。费用按每位患者每年(PPPY)计算,并按随访的第1、2、3、4和5年列出,以2014年美元表示。
共选取了108,790例银屑病患者,平均年龄为46.0岁(52.7%为女性)。平均随访时间为962天。全因医疗保健费用为每年每位患者12,523美元。门诊药房费用占总费用的38.6%。使用生物制剂的患者全因医疗保健费用最高(29,832美元),其次是患有银屑病关节炎的患者(23,427美元)和中重度疾病患者(21,481美元)。总体而言,全因医疗保健费用和门诊药房费用在5年期间呈上升趋势。
银屑病与重大经济负担相关,随着疾病进展,经济负担会随时间增加。中重度银屑病患者、患有银屑病关节炎的患者或使用生物制剂的患者会导致更高的医疗保健费用。银屑病相关的药房支出是银屑病患者医疗保健费用的最大驱动因素。