Using a single product (calcipotriene/betamethasone topical suspension) vs multiple products to manage body and scalp psoriasis: comparisons in resource utilization and costs

Abstract

Objectives:

To compare resource utilization and costs among patients who used calcipotriene/betamethasone dipropionate topical suspension (Taclonex Scalp Topical Suspension, Leo Pharma A/S) vs those who used multiple body and scalp formulations for psoriasis.

Research design and methods:

A retrospective study using Truven Health MarketScan Commercial Database from 2006–2011 was performed to identify patients with psoriasis (ICD code 696.1x). Two study cohorts analyzed were cohort A (used body-only formulations for psoriasis and switched on the index date to using calcipotriene/betamethasone dipropionate topical suspension alone) and cohort B (used multiple body and scalp formulations for psoriasis). Patients were required to be continuously enrolled during 180-days pre- and post-index periods. Multiple regression analyses adjusting for baseline demographic and clinical covariates were performed.

Main outcomes measures:

Number of psoriasis-related outpatient visits, total healthcare costs, psoriasis-related costs, and use of systemic agents during post-index period.

Results:

A total of 1923 patients were identified with at least one prescription for calcipotriene/betamethasone dipropionate scalp topical suspension (cohort A = 367, cohort B = 1556). Patients using multiple medications (cohort B) were associated with 48% higher number of outpatient visits as compared with those who used a single formulation (cohort A) after controlling for baseline covariates (p < 0.001). A generalized linear model adjusting for baseline covariates showed significantly higher post-index total and psoriasis-related healthcare costs for cohort B as compared with cohort A (both p < 0.001). Patients in Cohort B also had twice the odds of using systemic agents as compared to patients in Cohort A (p < 0.001).

Conclusions:

Patients with body and scalp psoriasis using a single product had significantly lower overall and psoriasis-related healthcare costs, needed fewer psoriasis-related outpatient visits, and used less systemic agents during the post-index period. A lack of robust clinical measures to define the disease severity may have limited the interpretations from this study.

Keywords::

• Psoriasis
• Scalp psoriasis
• Combination products
• Resource utilization
• Healthcare costs

Transparency

Declaration of funding

This study was supported by LEO Pharma, Inc.

Declaration of financial/other relationships

Dr Feldman is a consultant for LEO Pharma, Inc. Outcomes, Inc. provided editorial support. Dr Levi is an employee of Leo Pharma. Mr Pathak and Ms Kakatkar are paid consultants at Outcomes, Inc. Dr Balkrishnan is Principal Consultant to Outcomes, Inc. and provided research support for this study. JME Peer Reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

Previous Presentation: Poster Presentation at 2013 Winter Clinical Dermatology Conference, January 18–23, 2013, Grand Hyatt Kauai, Koloa, Hawaii.