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真实世界中接受系统性口服或生物制剂治疗的银屑病患者的治疗模式和医疗保健费用。

Real-world treatment patterns and healthcare costs in patients with psoriasis taking systemic oral or biologic therapies.

机构信息

Bristol Myers Squibb, Princeton, NJ, USA.

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

出版信息

J Dermatolog Treat. 2023 Dec;34(1):2176708. doi: 10.1080/09546634.2023.2176708.

Abstract

BACKGROUND

Psoriasis is a chronic, immune-mediated, systemic inflammatory disorder associated with high costs. This study evaluated real-world treatment patterns and associated costs in patients in the United States with psoriasis initiating systemic oral or biologic treatments.

METHODS

This retrospective cohort study used IBM (now Merative™) MarketScan Commercial and Medicare claims (1 January 2006-31 December 2019) to evaluate patterns of switching, discontinuation, and nonswitching in two cohorts of patients initiating oral or biologic systemic therapy. Total pre-switch and post-switch costs were reported per-patient per-month (PPPM).

RESULTS

Each cohort was analyzed (oral,  = 11,993; biologic;  = 9753). Among the oral and biologic cohorts, 32% and 15% discontinued index and any systemic treatment within 1 year of initiation; 40% and 62% remained on index therapy; and 28% and 23% switched treatment, respectively. In the oral and biologic cohorts, total PPPM costs within 1 year of initiation for nonswitchers, patients who discontinued, and patients who switched were $2594, $1402, and $3956, respectively, and $5035, $3112, and $5833, respectively.

CONCLUSION

This study identified lower persistence in the oral treatment cohort, higher costs associated with switching, and a need for safe and effective oral treatment options for patients with psoriasis to delay the switch to biologic therapy.

摘要

背景

银屑病是一种慢性、免疫介导的全身性炎症性疾病,相关费用较高。本研究评估了美国初治全身性口服或生物制剂治疗银屑病患者的真实世界治疗模式及相关费用。

方法

本回顾性队列研究使用 IBM(现为 Merative™)MarketScan 商业和医疗保险索赔数据(2006 年 1 月 1 日至 2019 年 12 月 31 日),评估了开始口服或生物制剂全身性治疗的两组患者中,药物转换、停药和未转换的模式。每例患者每月(PPPM)的预转换和转换后总费用均有报告。

结果

对两个队列(口服组,n=11993;生物制剂组,n=9753)进行了分析。在口服和生物制剂队列中,分别有 32%和 15%的患者在起始治疗后 1 年内停止了索引和任何全身性治疗;40%和 62%的患者仍在接受索引治疗;分别有 28%和 23%的患者转换了治疗方案。在口服和生物制剂队列中,起始治疗后 1 年内未转换者、停药者和转换者的总 PPPM 费用分别为 2594 美元、1402 美元和 3956 美元,5035 美元、3112 美元和 5833 美元。

结论

本研究发现,口服治疗组的患者持续性较低,转换的相关费用较高,因此需要为银屑病患者提供安全有效的口服治疗方案,以延迟向生物制剂治疗的转换。

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