Presentation (CTI)

OBJECTIVES: To describe the economic outcomes resulting from the implementation of a biological therapy optimization strategy in patients with immune-mediated skin diseases.
METHODS: A cross-sectional descriptive study was conducted in a cohort of patients diagnosed with immune-mediated dermatological conditions who received biological therapies during the years 2024-2025 at a specialized healthcare institution. Based on each patient's clinical evolution, optimization, and rational use strategies for biological treatment were applied. Subsequently, clinical safety and the economic impact of the implemented interventions were evaluated. Univariate statistical analysis was performed using the R software package (R Core Team, version 4.5.0, 2025).
RESULTS: The optimization strategy was applied to 981 patients, representing 14.1% of the total population treated (n=6962). Of these, 62.1% were women with a mean age of 44 years (SD: 18). The most frequent diagnoses were psoriasis (33.9%), urticaria (32.4%), atopic dermatitis (23.6%), and hidradenitis suppurativa (9.7%). The most used biological agents were omalizumab (32.3%), dupilumab (22%), adalimumab (18.3%), guselkumab (6.2%), ixekizumab (6%), and other biologics (15.2%). The main optimization strategies included extended dosing intervals (53.2%), complete discontinuation of biological therapy (21%), prevention of treatment initiation (17.2%), dose adjustment (5.6%), and switching to biosimilars (3%). All interventions resulted in adequate clinical responses. The most frequent measures were extended dosing intervals for dupilumab (14.6%) and omalizumab (13.1%), as well as the complete discontinuation of omalizumab (9.5%). The comprehensive implementation of these strategies resulted in an estimated total cost savings of USD 4,389,688.42.
CONCLUSIONS: The implementation of biological therapy optimization and rational use strategies in the management of immune-mediated dermatological diseases proved to be safe and clinically effective. Additionally, it demonstrated a favorable economic impact, significantly contributing to the financial sustainability of the healthcare system.