OBJECTIVES: To evaluate opioid and resource use among moderate-to-severe psoriasis (PsO) patients stratified by number of PsO-related comorbidities.

METHODS: Adults with PsO (≥2 diagnoses, the first being the index date) were identified in the OptumHealth Care Solutions, Inc. database of privately-insured patients (01/2010-03/2017). Patients with <12 months pre- and post-index coverage and preexisting PsO-related comorbidities were excluded. Moderate-to-severe patients were identified based on claims for any systemic or biologic therapy during the 12 month pre- or post-index periods. Systemic and biologic users were stratified by number of PsO-related comorbidities developed during the 12 month post-index period. Per-patient-per-year outpatient visits were evaluated post-index until the eligibility end or data cutoff.

RESULTS: Among 9,078 PsO patients, 1,475 received systemic therapy and 602 received biologics. Respectively, 58.8%, 35.4%, and 5.8% of systemic, and 51.3%, 40.2%, and 8.5% of biologic users developed 0, 1-2, or ≥3 comorbidities. During the 12-month pre-index period, 24.2% of systemic and 26.9% of biologic users received opioids, compared to 15.7% of non-PsO patients. Pre-index opioid use increased with comorbid burden both among systemic (21.3%, 27.8%, and 31.4% for 0, 1-2, and ≥3 comorbidities, respectively) and biologic (21.7%, 32.2%, and 33.3% for 0, 1-2, and ≥3 comorbidities, respectively) users. Post-index per-patient-per-year outpatient visit rates were 12.7, 16.4, and 24.2 among systemic and 10.4, 14.5, and 22.5 among biologic users with 0, 1-2, and ≥3 comorbidities, respectively. Relative to all moderate-to-severe patients, those additionally treated with opioids pre- or post-index had higher per-patient-per-year outpatient visit rates: 14.2, 18.8, and 26.7 among systemic and 11.5, 18.1, and 26.4 among biologic users with 0, 1-2, and ≥3 comorbidities, respectively.

CONCLUSIONS: Opioid use in moderate-to-severe PsO patients is substantial and increases with the number of PsO-related comorbidities. Relative to all moderate-to-severe PsO patients, healthcare resource use was higher among those treated with opioids.