Characteristics of Patients With Bullous Pemphigoid in the US Medicare Population
Author(s)
Francesca Barion, PhD1, CECILE BLEIN, PhD1, Arash Mahajerin, MD2, Charlotte E. Ward, PhD2, Tania Banerji, MPH, MS2;
1argenx, Ghent, Belgium, 2ZS Associates, Boston, MA, USA
1argenx, Ghent, Belgium, 2ZS Associates, Boston, MA, USA
OBJECTIVES: Bullous Pemphigoid (BP), the most common autoimmune blistering disease, predominantly affects the elderly, with an annual incidence of 10 cases per million in the United States. Real-world evidence studies which have assessed the BP patient population, have primarily been based on commercial insurance data and may not be generalizable to the overall BP population due to the advanced average age of individuals with BP. Thus, the objective of this study was to characterize BP patients above the age of 65 with Medicare insurance.
METHODS: A retrospective cohort study was conducted using Medicare claims data between January 2016 - December 2022. BP patients were selected based on presence of: (1) ≥ 2 BP claims ≥ 30 days apart, within 1-year post-index, and (2) continuous Medicare enrollment during a 2-year pre-index period.
RESULTS: Overall, 2,973 BP patients were identified, with a mean (SD) age of 79.7 (9.5) years, a mean (SD) Charlson Comorbidity Index CCI score of 3.3 (2.8), 57% female and 84% white. Nearly all patients received oral corticosteroids during the one-year follow up period (92%), which decreased to 50% by Year 4. Topical steroids were received by 63% of the patient population in Year 1, and 34% in Year 4. Non-steroidal immunosuppressants were utilized in 48% of the population in Year 1 and 29% in Year 4. Common conditions included dyslipidemia (62%), hypertension (81%), cardiac disease (37%), chronic kidney disease (33%), type 2 diabetes (40%), and osteoarthritis (31%).
CONCLUSIONS: The advanced age and high CCI scores of this cohort reflect significant comorbidity burdens in BP population. Corticosteroid use was present among nearly all patients which may present additional risks in patients with certain comorbidities. Thus, this study further underscores the need for targeted BP therapy to minimize corticosteroid use.
METHODS: A retrospective cohort study was conducted using Medicare claims data between January 2016 - December 2022. BP patients were selected based on presence of: (1) ≥ 2 BP claims ≥ 30 days apart, within 1-year post-index, and (2) continuous Medicare enrollment during a 2-year pre-index period.
RESULTS: Overall, 2,973 BP patients were identified, with a mean (SD) age of 79.7 (9.5) years, a mean (SD) Charlson Comorbidity Index CCI score of 3.3 (2.8), 57% female and 84% white. Nearly all patients received oral corticosteroids during the one-year follow up period (92%), which decreased to 50% by Year 4. Topical steroids were received by 63% of the patient population in Year 1, and 34% in Year 4. Non-steroidal immunosuppressants were utilized in 48% of the population in Year 1 and 29% in Year 4. Common conditions included dyslipidemia (62%), hypertension (81%), cardiac disease (37%), chronic kidney disease (33%), type 2 diabetes (40%), and osteoarthritis (31%).
CONCLUSIONS: The advanced age and high CCI scores of this cohort reflect significant comorbidity burdens in BP population. Corticosteroid use was present among nearly all patients which may present additional risks in patients with certain comorbidities. Thus, this study further underscores the need for targeted BP therapy to minimize corticosteroid use.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO14
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
SDC: Rare & Orphan Diseases, SDC: Sensory System Disorders (Ear, Eye, Dental, Skin), SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)