Medication use and associated health care outcomes and costs for patients with psoriasis in the United States

Abstract Background: The impacts of use of pharmacotherapy for psoriasis on patient outcomes and medication costs need further examination using up-to-date large nationally representative data. Objective: To examine the impacts of patient demographics and medication use on patient's health status and associated medication costs. Methods: A retrospective cross-sectional study was conducted using the 2007 Medical Expenditure Panel Survey (MEPS) database. Information on patient demographics, health status, medication utilization, and medication costs were obtained representing 543 231 patients with psoriasis. Results: Weighted multiple linear regression analyses indicated that the use of biological/systemic agents yielded an increase in patient health status among all types of medications (β = 7.9, p < 0.05). Use of biological/systemic agents also yielded an increase in annual medication spending (β = 2.5, p < 0.01). Use of biological agents was elevated compared to previous studies. Conclusions: We observed an association between medication use for psoriasis treatment and its related patient health status and medication spending. The study findings could imply that encouraging the use of topical treatments may be an effective means to increase patient health status. The use of biologics needs further cost-effectiveness studies given the findings that biologics contribute to substantial increases in both drug expenditures and patient health status.

[1]  Jipan Xie,et al.  Economic burden of psoriasis compared to the general population and stratified by disease severity , 2009, Current medical research and opinion.

[2]  A. Nast,et al.  A critical appraisal of evidence‐based guidelines for the treatment of psoriasis vulgaris: ‘AGREE‐ing’ on a common base for European evidence‐based psoriasis treatment guidelines , 2009, Journal of the European Academy of Dermatology and Venereology : JEADV.

[3]  S. Feldman,et al.  Increasing use of more potent treatments for psoriasis. , 2009, Journal of the American Academy of Dermatology.

[4]  J. Gelfand,et al.  The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003-2004. , 2009, Journal of the American Academy of Dermatology.

[5]  Elizabeth J Horn,et al.  Psoriasis: improving adherence to topical therapy. , 2008, Journal of the American Academy of Dermatology.

[6]  J. Fowler,et al.  The impact of psoriasis on health care costs and patient work loss. , 2008, Journal of American Academy of Dermatology.

[7]  A. Nast,et al.  Translating psoriasis treatment guidelines into clinical practice - the need for educational interventions and strategies for broad dissemination. , 2008, Journal of evaluation in clinical practice.

[8]  M. Augustin,et al.  Economic considerations in psoriasis management. , 2008, Clinics in dermatology.

[9]  Elizabeth J Horn,et al.  Psoriasis treatment patterns: results of a cross-sectional survey of dermatologists. , 2008, Journal of the American Academy of Dermatology.

[10]  D. Ford,et al.  Work Limitations and Productivity Loss Are Associated with Health-Related Quality of Life but Not with Clinical Severity in Patients with Psoriasis , 2006, Dermatology.

[11]  A. Gottlieb,et al.  Biologic therapies for psoriasis. A systematic review. , 2006, The Journal of rheumatology.

[12]  S. Feldman,et al.  Quality of life in patients with psoriasis , 2006, Health and quality of life outcomes.

[13]  A. Gottlieb,et al.  Psoriasis treatment: current and emerging directed therapies , 2005, Annals of the rheumatic diseases.

[14]  M. Lebwohl,et al.  Psoriasis treatment: traditional therapy , 2005, Annals of the rheumatic diseases.

[15]  S. Feldman,et al.  Psoriasis treatment in the United States at the end of the 20th century , 2004, International journal of dermatology.

[16]  W. Crown,et al.  The burden of illness associated with psoriasis: cost of treatment with systemic therapy and phototherapy in the US , 2004, Current medical research and opinion.

[17]  M. Sprangers,et al.  Quality of life in patients with psoriasis: a systematic literature review. , 2004, The journal of investigative dermatology. Symposium proceedings.

[18]  T. Kupper Immunologic targets in psoriasis. , 2003, The New England journal of medicine.

[19]  F. Camacho,et al.  Predictors of medication adherence and associated health care costs in an older population with type 2 diabetes mellitus: a longitudinal cohort study. , 2003, Clinical therapeutics.

[20]  M. Lebwohl,et al.  AAD consensus statement on psoriasis therapies. , 2003, Journal of the American Academy of Dermatology.

[21]  J. Koo,et al.  Quality of life issues in psoriasis. , 2003, Journal of the American Academy of Dermatology.

[22]  J. Callen New psoriasis treatments based upon a deeper understanding of the pathogenesis of psoriasis vulgaris and psoriatic arthritis: a personal appraisal of their use in practice. , 2003, Journal of the American Academy of Dermatology.

[23]  E. Frongillo,et al.  Marital status changes and body weight changes: a US longitudinal analysis. , 2003, Social science & medicine.

[24]  B. Sleath,et al.  Sociological influences on antidepressant prescribing. , 2003, Social science & medicine.

[25]  H. Javitz,et al.  The direct cost of care for psoriasis and psoriatic arthritis in the United States. , 2002, Journal of the American Academy of Dermatology.

[26]  M. Olfson,et al.  Prescription of psychotropic medications to youths in office-based practice. , 2001, Psychiatric services.

[27]  A. Belisari,et al.  The cost of hospital‐related care of patients with psoriasis in Italy based on the AISP study , 2001, Journal of the European Academy of Dermatology and Venereology : JEADV.

[28]  S. Feldman Advances in psoriasis treatment. , 2000, Dermatology online journal.

[29]  D. Ashcroft,et al.  Therapeutic strategies for psoriasis , 2000, Journal of clinical pharmacy and therapeutics.

[30]  Burden Management of psoriasis in childhood , 1999, Clinical and experimental dermatology.

[31]  C. Griffiths,et al.  Quality of life measures in psoriasis: a critical appraisal of their quality , 1998, Journal of clinical pharmacy and therapeutics.

[32]  P. C. van de Kerkhof,et al.  Evaluation of Topical Drug Treatment in Psoriasis , 1998, Dermatology.

[33]  A Bouckaert,et al.  Practical considerations on the use of the Charlson comorbidity index with administrative data bases. , 1996, Journal of clinical epidemiology.

[34]  R. Baughman A 61-year-old man with psoriasis. , 1996, JAMA.

[35]  R. Stern,et al.  The outcomes movement and new measures of the severity of psoriasis. , 1996, Journal of the American Academy of Dermatology.

[36]  R. Deyo,et al.  Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. , 1992, Journal of clinical epidemiology.

[37]  Ronald N. Forthofer,et al.  Analysis of Complex Sample Survey Data , 1986 .

[38]  I. Melnikova Psoriasis market , 2009, Nature Reviews Drug Discovery.

[39]  S. Feldman,et al.  Medication-related factors affecting health care outcomes and costs for patients with psoriasis in the United States. , 2005, Journal of the American Academy of Dermatology.

[40]  A. Kimball,et al.  The Psychosocial Burden of Psoriasis , 2005, American journal of clinical dermatology.

[41]  R. Aparasu,et al.  Autonomous ambulatory care by nurse practitioners and physician assistants in office-based settings. , 2001, Journal of allied health.

[42]  C. Mackenzie,et al.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. , 1987, Journal of chronic diseases.

[43]  E. Orenberg,et al.  Childhood psoriasis. , 1987, Cutis.