Treatment patterns, adherence, and persistence among psoriasis patients treated with biologics in a real-world setting, overall and by disease severity

Abstract

Purpose: Describe treatment patterns by disease severity among biologic-treated psoriasis patients.

Materials and methods: We selected our study cohort in the IQVIA PharMetrics Plus adjudicated claims database linked to Electronic Health Record data from Modernizing Medicine Data Services. Patients were classified as having mild, moderate, or severe psoriasis based on a hierarchy of available severity measures. Patients were followed for 360 days to assess combination therapy, therapy switching and restarting, adherence and persistence.

Results: The cohort comprised 2130 biologic-treated patients (mean age: 47.6 years; 45.4% female); 447 (21%) had available disease severity measures. Compared to patients with mild (N = 282) psoriasis, more patients with moderate (N = 116) or severe (N = 49) disease used combination therapy (21.3% vs. 34.5% and 32.7%, respectively), switched therapies (12.1% vs. 19.8% and 22.4%), and discontinued biologics (18.4% vs. 27.6% and 36.7%). Mean adherence was <75% by Medication Possession Ratio (MPR) (73.9%) and Proportion of Days Covered (PDC) (70.2%). Overall, 52.2% had a mean MPR >80%. Mean persistence to biologics was 297.6 days. Persistence and adherence decreased with increasing disease severity.

Conclusions: Biologic-treated psoriasis patients had inadequate adherence (i.e., MPR <80%) and modest persistence to biologics, with moderate and severe patients demonstrating lower adherence and persistence than mild patients.

Keywords:

• Psoriasis
• biologics
• psoriasis disease severity
• adherence
• persistence
• treatment patterns
• treatment discontinuation
• switching

Acknowledgements

The authors would like to acknowledge Magdaliz Gorritz (IQVIA) for her contributions to the programing and data analysis.

Disclosure statement

MJM, CKO, AZ, TMM, and ABA are employees of Lilly. AA, DC, and SAO are employees of IQVIA. JFM is an employee of Brigham and Women’s Hospital.

MJM, CKO, AZ, TMM, and ABA are owners of Lilly stock. JFM is a consultant for Biogen IDEC, AbbVie, Eli Lilly, Novartis, Pfizer, Janssen, UCB, Samumed, Science 37, Celgene, Sanofi Regeneron, Merck and GSK. Speaker for AbbVie. An investigator for Biogen IDEC, Pfizer, Sanofi Regeneron, Incyte, Novartis. Licensed outcome measure to AbbVie and Lilly. AA, DC, and SAO report no conflicts of interest.

Additional information

Funding

This study was funded by Eli Lilly and Company (Lilly).