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Analysis of drug utilization and health care resource consumption in patients with psoriasis and psoriatic arthritis before and after treatment with biological therapies

Authors Degli Esposti L, Perrone V, Sangiorgi D, Buda S, Andretta M, Rossini M, Girolomoni G

Received 20 March 2018

Accepted for publication 24 July 2018

Published 12 November 2018 Volume 2018:12 Pages 151—158

DOI https://doi.org/10.2147/BTT.S168691

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Dr Doris Benbrook


Luca Degli Esposti,1 Valentina Perrone,1 Diego Sangiorgi,1 Stefano Buda,1 Margherita Andretta,2 Maurizio Rossini,3 Giampiero Girolomoni4

1CliCon Srl, Health Economics and Outcomes Research, Ravenna, Italy; 2Pharmaceutical Department Local Health Unit, ULSS 9 Scaligera, Verona, Italy; 3Department of Medicine, Section of Rheumatology, University of Verona, Verona, Italy; 4Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy

Objectives: To describe the therapeutic pathways of patients with psoriasis (PSO) and psoriatic arthritis (PsA) before and after treatment with biological therapies in a real-world setting and to determine the relative consumption of health care resources.
Design: Retrospective observational study.
Setting: Real-life clinical setting in 5 Italian local health units.
Participants: A total of 351 male and female patients with at least 1 prescription for a biological drug from January 1, 2010 to December 31, 2013; patients with concomitant rheumatoid arthritis, ankylosing spondylitis, or Crohn’s disease were excluded.
Results: The major health care cost (excluding drug costs) was represented by hospitalizations, mainly related to PSO /PsA-associated disorders and cardiometabolic disorders. Use of conventional drugs among biologics-naïve patients reached 50% in PSO and 80% in PsA; their use decreased following initiation of biological therapy. After the start of biological treatment, the incidence of hospitalization decreased both for PSO (from 12.3% to 3.2% in day hospital regimen and from 2.4% to 0.4% for conventional admission) and for PsA (from 11.1% to 8.1% and from 10.1% to 3.0%, respectively). Mean annual costs for hospitalization before biological treatment were €217 and €537 for PSO and PsA, respectively, while mean annual cost for concomitant drugs slightly increased after biologics initiation: from €249.8 to €269.4 for PSO and from €331.8 to €346.9 for PsA. The major consumption of health care resources occurred in the quarter preceding the beginning of biological treatment.
Conclusion: The consumption of health resources is mostly related to hospitalization, seems to peak during the quarter before the beginning of biologics therapies, and subsequently decreases after biologics initiation. Further studies should focus on prescription scheme and economic burden of PSO and PsA in Italy to help optimize health care resources and potentiate services for patients.

Keywords: psoriasis, psoriatic arthritis, biological treatment, health care costs, hospitalization

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