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    Expense drivers for costliest psoriasis patients


    How biologics relate to psoriasis cost?

    Some previous studies have found, in contrast, that biologic medications are a substantial component of medical costs, or responsible for increased costs, in patients with psoriasis.2-3 The differences in the findings are mainly attributable to differences in methodology. The earlier studies focused on the biologic costs alone, or did not separate out pharmacy versus medical costs. In this study, Dr. Armstrong and colleagues stratified pharmacy and medical expenditures to determine the contribution of drug-related versus non-drug-related healthcare expenditure to the overall costs.

    Investigators acknowledged several caveats to the findings of this observational study. Notably, the administrative claims data the analysis was based upon is for purposes of payment, rather than research, and so may not contain all the information required for a confirmed diagnosis, medication adherence, or other factors.

    The group recently published another related study showing that use and cost of biologics did not differ significantly between patients incurring the highest 10% of total costs and the bottom 90%.4

    Lessons for providers

    Next, the group plans to examining the cost and health impact when patients are not placed on the most appropriate biologic first; i.e., the financial and clinical consequences when patients are cycling through multiple biologics.

    For dermatology providers, Dr. Armstrong says, it is important to note that psoriasis patients incur significant costs in managing sequelae of their comorbidities, such as arthritis, cardiometabolic diseases, neuropsychiatric diseases, and other immune-mediated conditions.

    “Being vigilant for these comorbidities, and ensuring that patients are screened and intervened early for their comorbid conditions, can not only improve patient outcomes but can also be cost effective in the long run,” she adds.


    The study was supported by Novartis Pharmaceuticals Corporation.

    Dr. Armstrong reports serving as investigator, advisor and/or consultant to AbbVie, Janssen, Novartis, Lilly, Regeneron, Sanofi, Modernizing Medicine, and Valeant.


    1 Armstrong AW, Zhao Y, Herrera V, et al. Drivers of Healthcare Costs Among the Costliest Patients With Psoriasis Over Three Years in a United States Health Plan. J Drugs Dermatol. 2017 Jul 1;16(7):651-658.

    2 Gleason PP, Alexander GC, Starner CI, et al. Health plan utilization and costs of specialty drugs within 4 chronic conditions. J Manag Care Pharm. 2013 Sep;19(7):542-8.

    3 Norlin JM, Steen Carlsson K, Persson U, Schmitt-Egenolf M. Resource use in patients with psoriasis after the introduction of biologics in Sweden. Acta Derm Venereol. 2015 Feb;95(2):156-61. doi: 10.2340/00015555-1895.

    4 Armstrong AW, Zhao Y, Herrera V, et al. Rethinking costs of psoriasis: 10% of patients account for nearly 40% of healthcare expenditures among enrollees with psoriasis in a U.S. health plan. Journal of Dermatological Treatment 2017 March 20, DOI: 10.1080/09546634.2017.1303566. Epub ahead of print.


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