Economic Burden Of Psoriatic Patients In The Brazilian Health System

Abstract

MCO) due to the severity of the conditions and their minimal budet impact. However, as interest by pharmaceutical companies, competition, and spend in the orphan drug category grows, payers are likely to look for ways to reduce or contain the cost. This is particularly true among pharmacy benefit products where payers have more effective utilization management tools at their disposal when compared to medical benefit products. Methods: This research assessed the Wholesale Acquisition Cost (WAC) of all non-oncology FDA designated pharmacy benefit orphan drugs that were launched 2004-2014 and plotted these against disease prevalence. The extent of payer management for these products was determined for the most common formulary design of 6 MCOs (2 national, 2 regional, and 2 integrated). Results: Stronger payer management of pharmacy benefit orphan drugs has emerged in select conditions where multiple labeled competitors with comparable levels of efficacy and material price differences exist, regardless of disease prevalence. The most common type of management introduced was either a 'preferred product' or 'step edit'. Integrated plans introduced stronger management more frequently when compared to national and regional plans. ConClusions: Given the increased payer spend in the orphan drug category, payers have begun to manage products in areas where cost savings can be achieved without sacrificing outcomes, irrespective of rare disease prevalence. In disease areas where multiple product options do not exist, payer management tended to be minimal, and typically only required a confirmation of a disease diagnosis through a Prior Authorization. While integrated health systems tend to have the tightest control on orphan products given their close physician relationships, national and regional plans have also begun to implement a similar level of control for select products.

Unmet needs in the management of psoriasis in Latin America: a systematic review

“…Contrary to most studies published in other regions, 64 , 65 , 66 , 67 , 68 Latin American literature did not find a statistically significant difference in work productivity across levels of Pso severity. 15 , 31 This discrepancy, however, may be attributed to the small sample sizes of these studies.…”

“…In contrast, Ferreira et al found no significant differences in absenteeism, presenteeism, overall work impairment, and activity impairment across varying levels of Pso severity. 31 …”