IDENTIFYING PREDICTORS OF HIGH-COST CARE IN GENERALIZED PUSTULAR PSORIASIS: INSIGHTS FROM U.S. REAL-WORLD DATA
Author(s)
Amit Garg, MD1, Mona Nili, PharmD, PhD, MBA, MS2, Lawrence Rasouliyan, MPH3;
1Zucker School of Medicine at Hofstra/Northwell, Department of Dermatology, New Hyde Park, NY, USA, 2LEO Pharma, Madison, NJ, USA, 3OMNY Health, Atlanta, GA, USA
1Zucker School of Medicine at Hofstra/Northwell, Department of Dermatology, New Hyde Park, NY, USA, 2LEO Pharma, Madison, NJ, USA, 3OMNY Health, Atlanta, GA, USA
OBJECTIVES: To characterize healthcare resource utilization (HCRU) and costs among patients with generalized pustular psoriasis (GPP) across total cost deciles, and to identify key factors associated with catastrophic costs.
METHODS: This retrospective cohort study used de-identified electronic health records from the OMNY Health Dermatology Platform linked with open claims (January 2017 to June 2025). Patients aged ≥12 years with a GPP diagnosis (ICD10: L40.1), overlapping claims, flare data, and ≥12 months pre-index and ≥6 months follow-up were included. Annualized costs per patient per year (PPPY) were stratified into deciles; catastrophic costs were defined as the top decile. Descriptive analyses summarized demographics, treatments, and HCRU. Quantile regression examined predictors across cost distribution, and logistic regression identified factors associated with catastrophic costs.
RESULTS: 2,798 GPP patients (mean age 56.7; 74.8% female; 84.5% White) were included in this study. Common comorbidities included cardiovascular disease (60.8%), systemic infection (53.3%), plaque psoriasis (45.9%), and anxiety (31.8%). At index, 69.2% used topical corticosteroids, 13.4% used biologics, and 16.6% used opioids. Emergency room visits averaged (± standard deviation) 0.5 ± 1.2 PPPY, hospitalizations 0.2 ± 0.9 PPPY, and hospital stay length among hospitalized patients 2.4 ± 2.8 days PPPY. The average total cost was USD 37,778 PPPY, with the top decile exceeding USD 94,792 PPPY. Higher total costs were associated with Medicare/Medicaid insurances, plaque psoriasis, psoriatic arthritis, depression, anxiety, cardiovascular disease, any oncologic disease and skin infection. Oral corticosteroids exposure and non-White race were notably associated only in the upper quantiles. Logistic regression confirmed higher odds of catastrophic costs with non-White race, Medicare/Medicaid insurances, plaque psoriasis, depression, anxiety, cardiovascular disease, and skin infection, while topical corticosteroid use lowered odds.
CONCLUSIONS: GPP imposes high economic burden, with catastrophic costs concentrated among patients with comorbidities, public insurances, and advanced treatment exposure. GPP-specific treatments may help mitigate extreme expenditures.
METHODS: This retrospective cohort study used de-identified electronic health records from the OMNY Health Dermatology Platform linked with open claims (January 2017 to June 2025). Patients aged ≥12 years with a GPP diagnosis (ICD10: L40.1), overlapping claims, flare data, and ≥12 months pre-index and ≥6 months follow-up were included. Annualized costs per patient per year (PPPY) were stratified into deciles; catastrophic costs were defined as the top decile. Descriptive analyses summarized demographics, treatments, and HCRU. Quantile regression examined predictors across cost distribution, and logistic regression identified factors associated with catastrophic costs.
RESULTS: 2,798 GPP patients (mean age 56.7; 74.8% female; 84.5% White) were included in this study. Common comorbidities included cardiovascular disease (60.8%), systemic infection (53.3%), plaque psoriasis (45.9%), and anxiety (31.8%). At index, 69.2% used topical corticosteroids, 13.4% used biologics, and 16.6% used opioids. Emergency room visits averaged (± standard deviation) 0.5 ± 1.2 PPPY, hospitalizations 0.2 ± 0.9 PPPY, and hospital stay length among hospitalized patients 2.4 ± 2.8 days PPPY. The average total cost was USD 37,778 PPPY, with the top decile exceeding USD 94,792 PPPY. Higher total costs were associated with Medicare/Medicaid insurances, plaque psoriasis, psoriatic arthritis, depression, anxiety, cardiovascular disease, any oncologic disease and skin infection. Oral corticosteroids exposure and non-White race were notably associated only in the upper quantiles. Logistic regression confirmed higher odds of catastrophic costs with non-White race, Medicare/Medicaid insurances, plaque psoriasis, depression, anxiety, cardiovascular disease, and skin infection, while topical corticosteroid use lowered odds.
CONCLUSIONS: GPP imposes high economic burden, with catastrophic costs concentrated among patients with comorbidities, public insurances, and advanced treatment exposure. GPP-specific treatments may help mitigate extreme expenditures.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD163
Topic
Real World Data & Information Systems
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), STA: Biologics & Biosimilars