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Initiation, Switching, and Cessation of Psoriasis Treatments Among Patients with Moderate to Severe Psoriasis in the United States

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Abstract

Background

Psoriasis patients frequently switch among multiple therapies while managing their psoriasis. Determining treatment transitions is fundamental to understanding how patients access and use treatments.

Objective

We aimed to identify patterns of treatment transitions of US patients with moderate to severe psoriasis over 5 years.

Methods

This was a retrospective, longitudinal cohort study in which US patients aged ≥18 years who had at least one psoriasis claim (International Classification of Diseases, Ninth Revision [ICD-9] diagnosis) were continuously enrolled in a health plan between October 2007 and September 2012. Data from eligible patients were projected to reflect the total US insured population with moderate to severe psoriasis, and the proportions of patients who started, stopped, switched, and restarted treatment at any time between September 2011 and September 2012 were analyzed. Treatment categories were biologics, traditional oral systemics, topicals, phototherapy, lapsed from treatment, and treatment-naive.

Results

There were 8.9 million patients in the claims database, of whom 0.9 million (10.4%) had a psoriasis diagnosis and 46,369 (0.5%) met the inclusion criteria. When projected, 1.7 million insured patients had moderate to severe psoriasis. Of these, an estimated 807,000 patients had lapsed treatment, an additional 346,000 were receiving treatment, and 547,000 were defined as being treatment-naive. A total of 81,000 of 346,000 patients had switched treatment in the preceding year. In addition, many patients stopped (438,000) and restarted (384,000) treatment in the 12-month period.

Conclusion

Based on health claims data, undertreatment of moderate to severe psoriasis appeared to be common.

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Acknowledgements

The authors are indebted to Neil Cockburn of Complete Medical Communications, who provided writing support funded by Pfizer Inc. under the direction of the authors, and Joaquim Nascimento of Vanguard Strategy, who provided intellectual input during the manuscript development process. Hernan Valdez and Gene Wallenstein, employees of Pfizer Inc., provided intellectual input during the manuscript development process. The views and opinions expressed within the manuscript are those of all authors and do not necessarily represent those of the funding organization. Data from this work were presented at meetings of the American Academy of Dermatology (Winter 2015), Dermatology Nurses’ Association (2015), and the National Psoriasis Foundation (2015).

Author information

Author notes

  1. Simon Rowse

    Present address: Capita plc, London, UK

Authors and Affiliations

  1. Department of Dermatology, University of Southern California, Los Angeles, CA, USA

    April W. Armstrong

  2. Kantar Insights, Wellington, New Zealand

    J. Will Koning

  3. Vanguard Strategy, London, UK

    Simon Rowse

  4. Pfizer Inc., Groton, CT, USA

    Huaming Tan & Carla Mamolo

  5. Global Product Development, Pfizer Inc., 445 Eastern Point Road, Groton, CT, 06340, USA

    Huaming Tan

  6. Pfizer Inc., Collegeville, PA, USA

    Mandeep Kaur

Authors
  1. April W. Armstrong
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  2. J. Will Koning
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  3. Simon Rowse
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  4. Huaming Tan
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  5. Carla Mamolo
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  6. Mandeep Kaur
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Corresponding author

Correspondence to Huaming Tan.

Ethics declarations

Funding

This work was funded by Pfizer Inc.

Conflicts of interest

April W. Armstrong is a consultant for AbbVie, Amgen, Eli Lilly, Janssen, Merck, and Pfizer Inc. J. Will Koning and Simon Rowse were employees of Vanguard Strategy, London, UK, at the time of the study, and were contracted to Pfizer Inc. Dr Carla Mamolo and Huaming Tan are employees and shareholders of Pfizer Inc. Dr Mandeep Kaur was an employee of Pfizer Inc. at the time of the study.

Ethical Approval

This was a retrospective study using health plan claims data compliant with the Health Insurance Portability and Accountability Act, exempt from Institutional Review Board requirements.

Informed Consent

This was a retrospective study using health plan claims data in which individual subjects cannot be identified.

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Armstrong, A.W., Koning, J.W., Rowse, S. et al. Initiation, Switching, and Cessation of Psoriasis Treatments Among Patients with Moderate to Severe Psoriasis in the United States. Clin Drug Investig 37, 493–501 (2017). https://doi.org/10.1007/s40261-017-0508-1

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