DOSING PATTERN ANALYSIS FOR BIOLOGICS IN THE TREATMENT OF PSORIASIS IN CANADA- INDICATION-SPECIFIC INFORMATION RETRIEVED FROM ADMINISTRATIVE CLAIMS DATABASE
Author(s)
Gregory V1, Liu N2, Robertson C2, Gerega S3, Barbeau M1, Budry L4
1Novartis Pharmaceuticals Canada Inc., Dorval, QC, Canada, 2IMS Health, Mississauga, ON, Canada, 3IMS Health, Kirkland, QC, Canada, 4Université de Montréal, Montreal, QC, Canada
OBJECTIVES: High cost biologic treatments for diseases such as plaque psoriasis, raise growing concerns over the increasing cost to the health care systems that are funding these treatments. Administrative databases can generate important information about the way these drugs are prescribed in a “real world” setting. The objectives of this analysis were to determine the initial dosing and identify dose escalation patterns for biologics in the treatment of psoriasis in Canada. METHODS: A sample of data from patients covered by the public (Quebec and Ontario) and private drug plans in Canada, who received a biologic between January 2010 and August 2012 for at least 12 months, were retrieved (IMS Brogan, IMS Longitudinal Claims Dataset, Jan 2010 - Aug 2013, reported Nov 2013). A specific algorithm was developed based on prescriber information and concomitant medications to capture claims associated to psoriasis. Dosing analysis was performed for four biologics approved for psoriasis in Canada: adalimumab, etanercept, infliximab and ustekinumab. Dose escalation was defined as a 20% dose increase above the previous dose, excluding induction. RESULTS: A total of 4,510 patients were identified and met inclusion criteria. The average first year dose was higher than years 2 and 3, consistent with the induction period for each drug. Overall, 63% of patients experienced a dose escalation, of which 68% occurred within the first year, excluding induction. Peak frequency of dose escalation occurred between weeks 11-30. Calculated daily, escalated dose was greater than maintenance by 9% for adalimumab, 14% for etanercept, and 28% for ustekinumab. CONCLUSIONS: Across all treatments, dose escalation was recorded in over 60% of patients, most often in the first year of treatment, indicating that patients may require additional doses to maintain response. These data highlight the need for new treatments which provide high sustained efficacy, with a rapid onset of action.
Conference/Value in Health Info
2015-05, ISPOR 2015, Philadelphia, PA, USA
Value in Health, Vol. 18, No. 3 (May 2015)
Code
PSY68
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Prescribing Behavior, Reimbursement & Access Policy
Disease
Systemic Disorders/Conditions