Zhdanava M1, Teeple A2, Pilon D3, Shak N4, Fitzgerald T2, Lefebvre P3
1Analysis Group, Inc., Montreal, QC, Canada, 2Janssen Scientific Affairs, LLC, Horsham, PA, USA, 3Analysis Group, Inc., Montréal, QC, Canada, 4Analysis Group, Inc., Menlo Park, CA, USA
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.
Conference/Value in Health Info
2019-05, ISPOR 2019, New Orleans, LA, USA
Value in Health, Volume 22, Issue S1 (2019 May)
Cost/Cost of Illness/Resource Use Studies