Comorbidity and economic burden among moderate-to-severe psoriasis and/or psoriatic arthritis patients in the US Department of Defense population

Abstract

Aims: To examine the comorbidity and economic burden among moderate-to-severe psoriasis (PsO) and/or psoriatic arthritis (PsA) patients in the US Department of Defense (DoD) population.

Materials and methods: This retrospective cohort claims analysis was conducted using DoD data from November 2010 to October 2015. Adult patients with ≥2 diagnoses of PsO and/or PsA (cases) were identified, and the first diagnosis date from November 2011 to October 2014 was defined as the index date. Patients were considered moderate-to-severe if they had ≥1 non-topical systemic therapy or phototherapy during the 12 months pre- or 1 month post-index date. Patients without a PsO/PsA diagnosis during the study period (controls) were matched to cases on a 10:1 ratio based on age, sex, region, and index year; the index date was randomly selected. One-to-one propensity score matching (PSM) was conducted to compare study outcomes in the first year post-index date, including healthcare resource utilization (HRU), costs, and comorbidity incidence.

Results: A total of 7,249 cases and 72,490 controls were identified. The mean age was 48.1 years. After PSM, comorbidity incidence was higher among cases, namely dyslipidemia (18.3% vs 13.5%, p < .001), hypertension (13.8% vs 8.7%, p < .001), and obesity (8.8% vs 6.1%, p < .001). Case patients had significantly higher HRU and costs, including inpatient ($2,196 vs $1,642; p < .0016), ambulatory ($8,804 vs 4,642; p < .001), emergency room ($432 vs $350; p < .001), pharmacy ($6,878 vs $1,160; p < .001), and total healthcare costs ($18,311 vs $7,795; p < .001).

Limitations: Claims data are collected for payment purposes; therefore, such data may have limitations for clinical research.

Conclusions: During follow-up, DoD patients with moderate-to-severe PsO and/or PsA experienced significantly higher HRU, cost, and comorbidity burden.

Keywords:

• Psoriasis
• psoriatic arthritis
• Department of Defense
• comorbidities
• economic burden

Transparency

Declaration of funding

This study was funded by Janssen Scientific Affairs, LLC.

Declaration of financial/other relationships

SL is an employee and stockholder in Johnson & Johnson, the parent company of Janssen Scientific Affairs, LLC, the study sponsor. LX, YW, and NV are employees of STATinMED Research, which is a paid consultant to Janssen Scientific Affairs, LLC, the study sponsor. OB has no interests to disclose. Peer reviewers on this manuscript have received an honorarium from JME for their review work. A peer reviewer on this manuscript has declared receiving funding from Janssen and other companies, including Abbvie, Celgene, Lilly, and Novartis. The remaining peer reviewers have no relevant financial relationships to disclose.

Acknowledgments

The authors wish to thank Chris Haddlesey of STATinMED Research for medical editorial support during manuscript development.

Previous presentation

This research has been presented at the American Academy of Dermatology (AAD) Annual Meeting in March 2017.