美国特应性皮炎患者的局部治疗利用情况以及克立硼罗软膏的预算影响分析，2。

Topical treatment utilization for patients with atopic dermatitis in the United States, and budget impact analysis of crisaborole ointment, 2.

作者信息

Clark Ryan, Bozkaya Duygu, Levenberg Mark, Faulkner Steven, Smith Timothy W, Gerber Robert A

机构信息

a Xcenda , Palm Harbor , FL , USA.

b Pfizer Inc. , Collegeville , PA , USA.

出版信息

J Med Econ. 2018 Aug;21(8):770-777. doi: 10.1080/13696998.2018.1470520. Epub 2018 May 21.

DOI:10.1080/13696998.2018.1470520

PMID:29706103

Abstract

BACKGROUND

Atopic dermatitis (AD), a chronic inflammatory skin disease, is often treated with topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI). Crisaborole ointment is a non-steroidal, phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate AD. In December 2016, crisaborole was approved in the US for mild-to-moderate AD in patients ≥2 years of age.

AIMS

To evaluate real-world utilization and cost of TCS and TCI in the US and estimate the budget impact of crisaborole over 2 years from a third-party payer perspective.

METHODS

TCS and TCI prescriptions in 2015 for patients ≥2 years of age with ≥1 AD diagnosis in the Truven Health Analytics MarketScan Commercial and Medicare Supplemental Research Databases were analyzed for patients receiving TCI or TCS alone or in combination (TCS/TCI population) and patients receiving TCI alone or in combination with TCS (TCI population). A budget impact model used TCS and TCI market shares, annual use, and cost per prescription. Crisaborole uptake rates of 4.7% (TCS) and 20.2% (TCI), with an annual increase of 1% in year 2, were assumed. Budget impact was calculated as total and per-member-per-month (PMPM) cost over 2 years for a health plan of 1 million members.

RESULTS

Annual prescriptions/patient ranged from 1.36-6.41; annual cost/patient was $53-$1,465. The budget impact of crisaborole over 2 years in the TCS/TCI population was $350,946 (PMPM, $0.015), with increases of $162,106 in year 1 (PMPM, $0.014) and $188,841 in year 2 (PMPM, $0.016). The budget impact in the TCI population was -$22,871, with decreases of $11,160 in year 1 and $11,712 in year 2 (each PMPM, -$0.001). For both populations, one-way sensitivity analyses showed that budget impact was most sensitive to changes in crisaborole cost and annual use.

CONCLUSIONS

From US payer perspectives, adoption of crisaborole results in modest pharmacy budget impact/savings.

摘要

背景

特应性皮炎（AD）是一种慢性炎症性皮肤病，常用外用糖皮质激素（TCS）和外用钙调神经磷酸酶抑制剂（TCI）进行治疗。克立硼罗软膏是一种用于治疗轻至中度AD的非甾体类磷酸二酯酶4抑制剂。2016年12月，克立硼罗在美国被批准用于治疗2岁及以上患者的轻至中度AD。

目的

从第三方支付方的角度评估美国TCS和TCI的实际使用情况和成本，并估计克立硼罗在2年内的预算影响。

方法

在Truven Health Analytics MarketScan商业和医疗保险补充研究数据库中，分析2015年2岁及以上至少有1次AD诊断的患者的TCS和TCI处方，这些患者单独接受TCI或TCS治疗或联合使用（TCS/TCI人群），以及单独接受TCI或与TCS联合使用的患者（TCI人群）。一个预算影响模型使用了TCS和TCI的市场份额、年使用量和每张处方的成本。假设克立硼罗的采用率为4.7%（TCS）和20.2%（TCI），第2年每年增加1%。预算影响计算为一个拥有100万成员的健康计划在2年内的总成本和每月人均成本（PMPM）。

结果

每年每张处方/患者的范围为1.36 - 6.41；每年每位患者的成本为53 - 1465美元。克立硼罗在TCS/TCI人群中2年的预算影响为350,946美元（PMPM，0.015美元），第1年增加162,106美元（PMPM，0.014美元），第2年增加188,841美元（PMPM，0.016美元）。TCI人群中的预算影响为 - 22,871美元，第1年减少11,160美元，第2年减少11,712美元（每次PMPM， - 0.001美元）。对于这两个人群，单向敏感性分析表明，预算影响对克立硼罗成本和年使用量的变化最为敏感。