Jung Hyemin, Kim Seong Rae, Cho Soo Ick, Jo Seong Jin
Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea.
Department of Education and Human Resource Developement, Seoul National University Hospital, Seoul, South Korea.
Sci Rep. 2024 Feb 20;14(1):4139. doi: 10.1038/s41598-024-54447-5.
Biologics for psoriasis are efficient and safe, but very expensive. We investigated the association of the reducing copayment program (RCP) with changes in biologics use patterns depending on the income levels of patients with moderate-to-severe psoriasis. This nationwide cohort study included patients identified as having moderate-to-severe psoriasis between 2014 and 2020. Logistic regression models were used to estimate the odds ratio for the use of biologics according to income levels. Among 57,139 patients with moderate-to-severe psoriasis, 3464 (6.1%) used biologics for psoriasis from 2014 to 2020. After the introduction of RCP in 2017, the proportion of patients with moderate-to-severe psoriasis using biologics rapidly increased from 5.0% in 2016 to 19.2% in 2020; the increase was more remarkable in patients with the lowest or mid-low income compared to those with Medical Aid. Drug survival of biologics was higher in patients with the highest income before the RCP, but became comparable between those with high and low incomes after RCP introduction. The introduction of RCP was associated with an increased use of biologics in patients with moderate-to-severe psoriasis of all income levels; however, the effect was more pronounced in low-income patients. The RCP may contribute to alleviating the disparity in access to biologics.
用于治疗银屑病的生物制剂有效且安全，但价格昂贵。我们研究了降低自付费用计划（RCP）与生物制剂使用模式变化之间的关联，该关联取决于中重度银屑病患者的收入水平。这项全国性队列研究纳入了2014年至2020年间被确诊为中重度银屑病的患者。采用逻辑回归模型根据收入水平估算使用生物制剂的比值比。在57139例中重度银屑病患者中，2014年至2020年期间有3464例（6.1%）使用生物制剂治疗银屑病。2017年引入RCP后，中重度银屑病患者使用生物制剂的比例从2016年的5.0%迅速增至2020年的19.2%；与医疗救助患者相比，低收入或中低收入患者的增幅更为显著。在引入RCP之前，高收入患者使用生物制剂的持续时间更长，但引入RCP后，高收入和低收入患者之间的持续时间变得相当。引入RCP与所有收入水平的中重度银屑病患者使用生物制剂的增加有关；然而，这种影响在低收入患者中更为明显。RCP可能有助于缓解生物制剂获取方面的差异。
