Increased biologic utilization in Latino patients with psoriasis

Abstract

Introduction

Hispanic/Latino populations are more likely to have extensive psoriasis than the non-Hispanic/Latino population. Biologics are indicated for moderate/severe psoriasis or psoriasis with comorbidities. No studies have assessed ethnicity as a predictor of biologic utilization. We aimed to determine if biologic utilization differs between Latinos and non-Latinos with psoriasis.

Methods

This study utilizes data from the National Ambulatory Medical Care Survey (NAMCS) from 2003 to 2016. Psoriasis visits were selected by International Classification of Diseases, Ninth or Tenth Revision (ICD-9/ICD-10) classification. The primary outcome is biologic use at the time of visit.

Results

Of 1202 psoriasis visits, Latinos consisted of 9.7% (95% Confidence Interval 7.3–12) of the study population and 65% (95%CI 61–69) used private insurance. Multivariate analysis reveals the increased likelihood of biologic utilization in Latinos compared to non-Latinos (Odds Ratio (OR) 2.4, 95% CI 1.1–5.4, p = .03). Independently, private insurance status is associated with increased biologic use compared to public insurance (OR 2.4, 95% CI 1.2–5.0, p = .02). Private insurance status did not differ between Latinos and non-Latinos with psoriasis (OR 1.0, 95% CI 0.5–1.9, p = .98).

Conclusions

Hispanic/Latino ethnicity and private insurance status are independent predictors of biologic utilization, suggesting that biologic mechanisms may influence the increased use of biologics in Latinos with psoriasis.

Keywords:

• Psoriasis
• biologics
• hispanic
• Latino

Disclosure statement

Tammy Gonzalez has no conflict of interest or financial disclosures. Alan Fleischer is a consultant for Boehringer-Ingelheim, Dermavant, Incyte, Qurient, SCM Lifescience and Syneos. He is an investigator for Galderma, Menlo and Trevi. He has no other potential conflicts including Honoraria, Speakers bureau, Stock ownership or options, Expert testimony, Grants, Patents filed, received, pending, or in preparation, Royalties, or Donation of medical equipment.