Real‐World Treatment Patterns and Healthcare Costs in Patients with Psoriatic Arthritis Treated with Ixekizumab: A Retrospective Study

Abstract

Objective To describe adherence, persistence, discontinuation, restarting, switching, dosing, and health care costs among patients with psoriatic arthritis (PsA) treated with ixekizumab (IXE). Methods MarketScan administrative claims databases were used to select adults (≥18 years) initiating IXE between January 1, 2016, and June 30, 2019, for this retrospective study (earliest IXE claim = index). Eligible patients had one or more PsA diagnoses during the 12 months preceding the index and had 12 months of follow‐up time after the index. Adherence (measured by proportion of days covered [PDC]) persistence (<60‐day gap), discontinuation (≥90‐day gap), switching, and dosing patterns were reported. Health care costs were reported per patient per month (PPPM) during follow‐up and were assessed after adjusting PsA treatment costs for discount rates reported by the Institute for Clinical and Economic Review (ICER). Results A total of 496 patients met the selection criteria (mean age, 51.1 years; 50.4% female). Over the 12‐month follow‐up, 52.8% remained persistent, 38.7% discontinued, 13.5% had no other treatment, 4.6% restarted, and 20.6% switched to a new biologic/traditional synthetic disease‐modifying antirheumatic drug. 70.6%of patients were identified as highly adherent (i.e. PDC > 0.80)to IXE prior to discontinuation. Dose values were consistent with prescribing information for patients with and without comorbid psoriasis. Although IXE costs ($5233 [SD = $2497]) accounted for 85.6% of PsA‐related health care costs, only 3.5% of IXE costs were patient out‐of‐pocket expenses. Adjusting for the ICER discounts decreased all‐cause and PsA‐related costs by $2509 PPPM. Conclusion Results from this real‐world analysis suggest that treatment patterns and costs among patients with PsA initiating IXE are consistent with prior literature for other biologics.

Analysis of the Pharmacoutilization of Biological Drugs in Psoriatic Arthritis Patients: A Real-World Retrospective Study Among an Italian Population

“…Over 50% of IXE patients were bionaïve, and almost 30% took IL inhibitors before the initiation of ixekizumab therapy. This result is in contrast with the previous finding that found that nearly 90% of IXE patients were bioexperienced [ 35 ], but further research on patients taking IXE should be performed to confirm these data.…”

“…Thus, in the present study, a focused analysis on IXE patients was performed. The patients' characteristics were comparable to those of another real-world study on the use of IXE in PsA patients among the US population [ 35 ]. In our research, almost 90% of the patients taking IXE had a PSO manifestation, which is in line with findings reported by Murage et al [ 35 ] from a study carried out in IXE-treated PsA patients.…”

“…The patients' characteristics were comparable to those of another real-world study on the use of IXE in PsA patients among the US population [ 35 ]. In our research, almost 90% of the patients taking IXE had a PSO manifestation, which is in line with findings reported by Murage et al [ 35 ] from a study carried out in IXE-treated PsA patients. Our data, despite being derived from a small-sample population of patients, could be explained by the fact that patients were included during 2017, which is before the approval of IXE for the treatment of PsA in Europe.…”

“…Our data, despite being derived from a small-sample population of patients, could be explained by the fact that patients were included during 2017, which is before the approval of IXE for the treatment of PsA in Europe. Thus, the high percentage of IXE-treated PsA patients could be referred to those who started IXE treatment after being prescribed by a dermatologist with the intent of treating the PSO manifestation [ 35 ]. In addition, these data are in line with the recommendations that encourage the use of IL-12/23 inhibitors or IL-17 inhibitors in patients with relevant skin involvement [ 9 ].…”

Persistence and Use of Ixekizumab in Patients with Psoriatic Arthritis in Real-World Practice in Spain. The PRO-STIP Study

“…There is limited RWE assessing IXE in PsA patients available in the literature to put our results in context. Two studies conducted in the United States assessed the sociodemographic characteristics, treatment patterns, and IXE persistence in PsA patients included in two claims databases (MarketScan administrative claims and Truven Databases) [ 15 , 16 ]. At the European level, the main evidence comes from two Italian and one Spanish study.…”