The economic burden of psoriasis with high comorbidity among privately insured patients in the United States. (1st February 2019)

• Record Type: Journal Article
• Authors: Pilon, Dominic; Teeple, Amanda; Zhdanava, Masha; Ladouceur, Martin; Ching Cheung, Hoi; Muser, Erik; Lefebvre, Patrick
• Is Part Of: Journal of medical economics. Volume 22:Number 2(2019)
• Page Start: 196
• Page End: 203
• Publication Date: 2019-02-01
• Subjects: Psoriasis -- comorbidities -- healthcare use -- costs -- indirect costs -- work loss -- economic burden; I10 -- I00; Medical care -- Cost control -- Periodicals; Medical economics -- Periodicals; 362.10941
• DOI: 10.1080/13696998.2018.1557201
• Languages: English
• ISSNs: 1369-6998

Abstract

Abstract: Objective: To evaluate the impact of comorbidities on healthcare resource use (HRU), and direct and indirect work-loss-related costs in psoriasis patients. Methods: Adults with psoriasis (≥2 diagnoses, the first designated as the index date) and non-psoriasis controls (no psoriasis diagnoses, randomly generated index date) were identified in a US healthcare claims database of privately-insured patients (data between January 2010 and March 2017 were used). Psoriasis patients were stratified based on the number of psoriasis-related comorbidities (0, 1–2, or ≥3) developed during the 12 months post-index. All outcomes were evaluated during the follow-up period, spanning the index date until the end of continuous health plan eligibility or data cut-off. HRU and costs per-patient-per-year (PPPY) were compared in psoriasis and non-psoriasis patients with ≥12 months of follow-up. Results: A total of 9, 078 psoriasis (mean age = 44 years, 51% female) and 48, 704 non-psoriasis (mean age = 41 years, 50% female) patients were selected. During the 12 months post-index, among psoriasis vs non-psoriasis patients, 71.0% vs 83.0% developed no psoriasis-related comorbidities, 26.3% vs 16.0% developed 1–2, and 2.6% vs 1.0% developed ≥3 psoriasis-related comorbidities. Compared to non-psoriasis patients, psoriasis patients had more HRU including outpatient visits (incidence rate ratios [IRRs] = 1.52, 2.03, and 2.66 for 0, 1–2, and ≥3 comorbidities, respectively [all p < 0.01]) and emergency room visits (IRRs = 1.12, 1.59, and 2.45 for 0, 1–2, and ≥3 comorbidities, respectively [all p < 0.01]) during the follow-up period. Psoriasis patients incurred greater total healthcare costs (mean cost differences [MCDs] = $1, 590, $5, 870, and $18, 427, in patients with 0, 1–2, and ≥3 comorbidities, respectively [all p < 0.01]), and work-loss-related costs (MCDs = $335, $655, and $1, 695, in patients with 0, 1–2, and ≥3 comorbidities, respectively [all p < 0.01]). Conclusions: HRU and cost burden of psoriasis are substantial, and increase with the development of psoriasis-related comorbidities.