Unraveling the Disease Burden of Generalized Pustular Psoriasis: A Comparative Analysis of Flares with Psoriasis Vulgaris in Taiwan

Speaker(s)

Tseng CY1, Lu CW2, Chung WH3, Lin FJ4
1Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, GAINESVILLE, FL, USA, 2Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan, 3Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan, 4Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan

Presentation Documents

OBJECTIVES: Generalized pustular psoriasis (GPP) is a rare and life-threatening skin inflammatory disease characterized by intermittent systemic acute flares. This study aimed to assess patient characteristics, healthcare resource utilization (HCRU), and costs associated with GPP flares in Taiwan.

METHODS: This study utilized Taiwan’s national claims database to identify patients diagnosed with GPP (ICD-10-CM code L40.1) who received related systemic treatment between January 2017 and September 2020. Exclusions were made for patients with GPP during pregnancy or having a prior diagnosis of psoriasis vulgaris (PV). Flares within the study period were identified using intensified systemic dermatological treatment. A matched PV (ICD-10-CM code L40.0) cohort (with a 1:3 matching ratio) based on age, sex, and cohort entry year was randomly selected for comparison. In addition to patient characteristics, all-cause outpatient/inpatient utilization and costs within 12 weeks after the flare were assessed.

RESULTS: A total of 243 GPP patients (with 1,151 flares) and 724 matched PV control (with 3,176 flares) were identified. The most common comorbidities in both GPP and PV patients include hypertension, thyroid disease, diabetes mellitus, and dyslipidemia. Regarding flares, GPP flares were associated with a higher likelihood of seeking emergency care (14.4% vs. 9.4%) and being hospitalized (18.2% vs. 5.6%) compared to PV flares. Among those requiring hospitalization, GPP flares also resulted in a longer hospital stay (median: 10 days vs. 7 days) and a higher admission rate to the intensive care unit (ICU) (1.6% vs. 0.8%) compared to PV flares. Additionally, GPP flares incurred higher costs (median: NTD 26,190 vs. NTD 16,758).

CONCLUSIONS: This study highlights the substantial burden associated with GPP flares, as indicated by increased HCRU and costs compared to PV flares. These findings underscore the need for targeted interventions to mitigate the impact of GPP on patients and the healthcare system.

Code

EE412

Topic

Economic Evaluation, Health Policy & Regulatory, Real World Data & Information Systems, Study Approaches

Topic Subcategory

Health & Insurance Records Systems, Public Spending & National Health Expenditures

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)