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Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis
INTRODUCTION: We compared treatment switch patterns and healthcare costs among biologic-naive patients with psoriatic arthritis (PsA) who initiated apremilast or biologics. METHODS: A 1:2 propensity score match was used to adjust administrative claims data for adults initiating apremilast or biologi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467475/ https://www.ncbi.nlm.nih.gov/pubmed/32141018 http://dx.doi.org/10.1007/s12325-020-01262-9 |
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author | Wu, Jashin J. Pelletier, Corey Ung, Brian Tian, Marc Khilfeh, Ibrahim Curtis, Jeffrey R. |
author_facet | Wu, Jashin J. Pelletier, Corey Ung, Brian Tian, Marc Khilfeh, Ibrahim Curtis, Jeffrey R. |
author_sort | Wu, Jashin J. |
collection | PubMed |
description | INTRODUCTION: We compared treatment switch patterns and healthcare costs among biologic-naive patients with psoriatic arthritis (PsA) who initiated apremilast or biologics. METHODS: A 1:2 propensity score match was used to adjust administrative claims data for adults initiating apremilast or biologics from January 1, 2014, to September 30, 2016, for possible selection bias. Patients had at least 12 months of pre- and post-index continuous enrollment in the Optum Clinformatics™ Data Mart database. Outcomes included switch frequency, days to switch, adherence on index treatment, and healthcare costs (total and per patient per month). Switch rate was defined as the proportion of patients who switched to a new treatment after initiation of the index treatment, and days to switch was calculated as the days between initiation of the index treatment and initiation of the new treatment. Adherence was calculated using the proportion of days covered and the medication possession ratio. The t test and chi-square, Kaplan–Meier, and Wilcoxon rank-sum tests were used to evaluate differences between the cohorts. RESULTS: Patient characteristics and switch rates were similar between the matched apremilast (n = 170) and biologic (n = 327) cohorts. After matching, patient characteristics were similar between the matched cohorts. The 12-month switch rates were similar for patients initiating apremilast versus those on biologics (17.7% vs. 25.1%, P = 0.06). This trend was similar at 6 months (7.7% vs. 13.2%, P = 0.07) and 18 months (24.4% vs. 29.3%, P = 0.33). Regardless of treatment switching, 12-month total healthcare costs were lower with apremilast versus biologics (all: $28,423 vs. $41,178, P < 0.0001; switched: $39,803 vs. $51,517, P = 0.0040; did not switch: $25,984 vs. $37,717, P < 0.0001). CONCLUSIONS: Biologic-naive patients with PsA who initiated apremilast had switch rates similar to biologic users and significantly lower healthcare costs, regardless of treatment switching. |
format | Online Article Text |
id | pubmed-7467475 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-74674752020-09-11 Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis Wu, Jashin J. Pelletier, Corey Ung, Brian Tian, Marc Khilfeh, Ibrahim Curtis, Jeffrey R. Adv Ther Original Research INTRODUCTION: We compared treatment switch patterns and healthcare costs among biologic-naive patients with psoriatic arthritis (PsA) who initiated apremilast or biologics. METHODS: A 1:2 propensity score match was used to adjust administrative claims data for adults initiating apremilast or biologics from January 1, 2014, to September 30, 2016, for possible selection bias. Patients had at least 12 months of pre- and post-index continuous enrollment in the Optum Clinformatics™ Data Mart database. Outcomes included switch frequency, days to switch, adherence on index treatment, and healthcare costs (total and per patient per month). Switch rate was defined as the proportion of patients who switched to a new treatment after initiation of the index treatment, and days to switch was calculated as the days between initiation of the index treatment and initiation of the new treatment. Adherence was calculated using the proportion of days covered and the medication possession ratio. The t test and chi-square, Kaplan–Meier, and Wilcoxon rank-sum tests were used to evaluate differences between the cohorts. RESULTS: Patient characteristics and switch rates were similar between the matched apremilast (n = 170) and biologic (n = 327) cohorts. After matching, patient characteristics were similar between the matched cohorts. The 12-month switch rates were similar for patients initiating apremilast versus those on biologics (17.7% vs. 25.1%, P = 0.06). This trend was similar at 6 months (7.7% vs. 13.2%, P = 0.07) and 18 months (24.4% vs. 29.3%, P = 0.33). Regardless of treatment switching, 12-month total healthcare costs were lower with apremilast versus biologics (all: $28,423 vs. $41,178, P < 0.0001; switched: $39,803 vs. $51,517, P = 0.0040; did not switch: $25,984 vs. $37,717, P < 0.0001). CONCLUSIONS: Biologic-naive patients with PsA who initiated apremilast had switch rates similar to biologic users and significantly lower healthcare costs, regardless of treatment switching. Springer Healthcare 2020-03-05 2020 /pmc/articles/PMC7467475/ /pubmed/32141018 http://dx.doi.org/10.1007/s12325-020-01262-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Research Wu, Jashin J. Pelletier, Corey Ung, Brian Tian, Marc Khilfeh, Ibrahim Curtis, Jeffrey R. Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis |
title | Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis |
title_full | Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis |
title_fullStr | Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis |
title_full_unstemmed | Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis |
title_short | Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis |
title_sort | treatment switch patterns and healthcare costs in biologic-naive patients with psoriatic arthritis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467475/ https://www.ncbi.nlm.nih.gov/pubmed/32141018 http://dx.doi.org/10.1007/s12325-020-01262-9 |
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