A Claims Analysis to Characterize the Economic Burden of Generalized Pustular Psoriasis Among Patients in the United States

OBJECTIVES: Literature describing healthcare resource utilization (HCRU) and costs incurred by patients with generalized pustular psoriasis (GPP) in the US is limited. This study aims to characterize the economic burden associated with GPP by comparing all-cause HCRU and all-cause costs between cohorts of patients with GPP and patients with psoriasis (PsO).

METHODS: Four cohorts (GPP-only, GPP with comorbid PsO [GPP+PsO], All-GPP [GPP-only and GPP+PsO], and PsO-only) were identified from Inovalon Insights real-world claims data over 4 years (January 2016 to December 2019). HCRU and costs were identified for four categories each: inpatient, emergency room (ER), office, and outpatient visits; and total cost, inpatient/ER costs, outpatient/office costs, and prescription costs. Adjusted mean all-cause HCRU and all-cause costs were calculated using a binomial regression model and the adjusted mean difference per member per month (PMPM) was calculated by subtracting adjusted means.

RESULTS: The All-GPP and GPP+PsO cohorts had significantly more all-cause inpatient stays, ER visits, office visits, and outpatient visits over the study period compared with the PsO-only cohort (all p<0.001). While no patient in the propensity score matched Plaque PsO cohort has been hospitalized, about 5% of the GPP patients incurred inpatient costs, the highest costs were noticed in the ICU with about 84K USD. In addition, a dozen patients incurred ER-related costs, while all hospitalized patients had mean inpatient costs of 6,909 USD. Total condition-related mean costs of GPP patients (945 USD) were about 3.2 times higher than those of patients with plaque PsO, while the outpatient/office costs of GPP demonstrated about 1.6 times higher costs (430 USD) compared to plaque PsO.

CONCLUSIONS: In the US, patients with GPP (with or without comorbid PsO) had higher HCRU than patients with PsO-only. Patients with GPP generally incurred higher costs than those with PsO-only. This highlights the economic burden and unmet need among GPP cohorts.