Psoriasis treatment patterns with etanercept and adalimumab in a United States health plan population

Abstract

Background: A retrospective study utilizing administrative claims from a US commercial health plan was performed to examine etanercept and adalimumab treatment patterns among patients with psoriasis (PSO). Methods: Biologic-naïve PSO patients initiating etanercept or adalimumab therapy between 18 January 2008 and 31 December 2008 were identified. Patients continuously enrolled in the health plan for 6 months before and ≥12 months after therapy initiation were followed until disenrollment from the plan or 31 December 2009. Persistence was defined as continuous use of index TNF blocker without a gap in therapy ≥60 days. Patients with gaps in index therapy ≥60 days were classified as discontinuing, switching, or restarting the index therapy. Results: In total, 497 patients initiated etanercept and 330 the adalimumab therapy. Mean age for both groups was 43 years. Approximately 40–42% of patients were persistent on their index TNF blocker for 1 year. Among patients with a ≥60-day gap in therapy, discontinuation without restart or switch occurred in 37% of etanercept and 45% of adalimumab patients (p = 0.04). Differences in therapy restart or switching between the groups were not statistically significant. Conclusions:TNF-blocker therapy persistence is low among PSO patients in this health plan. More than one-third of patients restarted their index TNF blocker after a gap in therapy.

Key words::

• psoriasis
• etanercept
• adalimumab
• treatment patterns

Acknowledgements

The authors thank Gretchen E. Parker, PhD, RAC, medical writer at OptumInsight, for her assistance in the preparation of this manuscript.

Declaration of interest: This study was funded by Immunex Corporation, a wholly owned subsidiary of Amgen Inc, and by Wyeth, which was acquired by Pfizer, Inc. in October 2009. Benjamin Chastek and Gretchen Parker are employed by OptumInsight, which was contracted by Amgen to conduct this study. Crystal Watson, Gregory Kricorian, and Shravanthi Gandra are employees of Amgen, Inc. and have received Amgen stock/stock options; Strategic Healthcare Solutions, LLC (Kathleen Fox) received research funds from Amgen, Inc. as a consultant.