Real-world biologic treatment patterns and healthcare resource utilization in psoriasis patients using an insurance claims database in Japan

Abstract

Background

With advent of newer treatments for psoriasis, real-world use of biologics in Japan is evolving.

Methods

This retrospective study utilized data from patients with ≥1 psoriasis-related biologic claims record between January 2016 and December 2020 in Japan to evaluate treatment patterns, healthcare resource utilization (HCRU), and associated costs. Data were analyzed using descriptive statistics.

Results

Of 1,614 eligible patients, 72.5% were male, 29.2% had comorbid hypertension and 26.6% had comorbid cardiovascular disease. Interleukin (IL)-17 and tumor necrosis factor alpha (TNFα) inhibitors were commonly prescribed across lines of treatment, while IL-23 inhibitors were most considered for switches (92% of switches were from IL-12/23/IL-17/TNFα inhibitors). The overall mean adherence rate for all classes was 80.1%, but adherence varied across biologics. Infliximab and IL-23 inhibitor users exhibited optimal medical possession ratios, reflecting the best adherence rates. Overall HCRU (visits/patient-year) was 9.05 for outpatient visits, 0.09 for inpatient hospitalization, and 0.5 for psoriasis-related phototherapy. HCRU associated with hospitalization was slightly higher for bio-experienced patients and so was the overall costs per patient-year relative to bio-naïve patients.

Conclusion

Variable adherence rates observed suggest the need for improvement in treatment management with different biologics. Bio-experienced patients burdened by disease progression and treatment switches may result in increased HCRU.

Keywords:

• Biologics
• healthcare resource utilization
• psoriasis
• treatment pattern

Acknowledgement

The authors thank Sonali Satam, Ph.D, for providing writing support and Uma Kundu, MPharm, CMPP^TM for additional editorial support (All SIRO Clinpharm Pvt. Ltd., Maharashtra, India).

Author contributions

Celine Miyazaki (Janssen Pharmaceutical K.K., Japan) developed the initial outline draft of this manuscript, including the data tables and figures from the results analysis of the study. All authors contributed to the development and review of this manuscript and confirm that they have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. All authors met ICMJE criteria and all those who fulfilled those criteria are listed as authors. All authors had access to the analyzed data, rigorously reviewed the data output and interpretation, and made the final decision about where to publish these data and approved submission to this journal.

Disclosures

Celine Miyazaki, Junya Masuda and Phiona I-Ching Tsai are employees of Janssen Pharmaceutical K.K., Japan at the time the study was completed and may own stock in Johnson & Johnson. Hidehisa Saeki received lecture fees from Mitsubishi Tanabe Pharma Corporation, Taiho Pharmaceutical Co., Ltd., Torii Pharmaceutical Co. Ltd., Maruho Co., Ltd., Kyowa Kirin Co., Ltd., AbbVie GK, Novartis Pharma K.K., Eli Lilly Japan K.K., LEO Pharma K.K., Celgene Corp., Janssen Pharmaceutical K.K., UCB Japan Co. Ltd. and/or research costs, Maruho Co., Ltd, AbbVie GK, LEO Pharma K.K; and/or scholarship donations from Taiho Pharmaceutical Co., Ltd., Maruho Co., Ltd., Eisai Co., Ltd., and Sun Pharma Japan Ltd. Mateo Delclaux Rodriguez-Rey is an employee of Paraxel International, London. Marta Natalia Stelmaszuk and Jonatan Freilich are employees of Parexel International, Sweden.

Data availability

The data that support the findings of this study are available from JMDC Inc. Restrictions apply to the availability of these data, which were used under license for this study. Data could be available on request with the permission of JMDC Inc.

Additional information

Funding

Data acquisition, research, and preparation of the manuscript were funded by Janssen Pharmaceutical K.K. The funding body did not have any additional role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript.