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The economic burden of psoriasis with high comorbidity among privately insured patients in the United States.
Journal of Medical Economics 2018 December 8
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 01/2010 and 03/2017 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 cutoff. 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 versus non-psoriasis patients, 71.0% versus 83.0% developed no psoriasis-related comorbidities, 26.3% versus 16.0% developed 1-2, and 2.6% versus 1.0% developed 3 or more 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 development of psoriasis-related comorbidities.
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 01/2010 and 03/2017 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 cutoff. 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 versus non-psoriasis patients, 71.0% versus 83.0% developed no psoriasis-related comorbidities, 26.3% versus 16.0% developed 1-2, and 2.6% versus 1.0% developed 3 or more 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 development of psoriasis-related comorbidities.
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