Real-world biologic and apremilast treatment patterns andhealthcare costs in moderate-to-severe plaque psoriasis

摘要

Plaque psoriasis is a chronic disease requiring long-termtherapy. However, long-term real-world treatmentpatterns and costs are not well characterized. This studyexamined treatment patterns and healthcare costsamong patients newly initiating a biologic or apremilastfor moderate-to-severe plaque psoriasis. Includedpatients had ?1 prescription for secukinumab,ixekizumab, adalimumab, ustekinumab, etanercept, orapremilast between 01/01/2015 and 08/31/2018, noprior use of the index medication, and continuousenrolment 12 months pre-index and 24 months postindex. Treatment adherence, non-persistence,discontinuation, switching, use of combination therapy,and re-initiation were assessed at 12, 18, and 24 monthspost-index. In addition, total and psoriasis-relatedhealthcare costs were evaluated at 24 months. A total of7,773 patients with 24-month follow-up were included.Overall, adherence was low (21.3%–33.5%) and nonpersistence was high (58.4%–86.5%) over 24 months.Discontinuation (38.4%–51.3%), switching (29.7%–52.6%), combination therapy (27.6%–42.9%), and reinitiation of the index medication (19.3%–44.5%) werecommon. Healthcare costs were high and mostlycontributed by psoriasis treatment. Therefore,maintaining disease control on long-term therapy is stillchallenging for many patients.