Resource Use in Patients with Psoriasis After the Introduction of Biologics in Sweden

Norlin, Jenny M.; Carlsson, Katarina Steen; Persson, Ulf; Schmitt‐Egenolf, Marcus

doi:10.2340/00015555-1895

Cited by 14 publications

(14 citation statements)

References 29 publications

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“…On an annualized basis, HCRU cost estimates in the 3 studies were USD 1,043 (34), USD 2,645 (35), and USD 11,356 (36). Annualized estimates of cost of productivity losses in the 3 studies were USD 1,500 (35), 3,190 (36), and approximately USD 13,500 (34). The differences may reflect patient recruitment strategy, inclusion/exclusion criteria, and differences in definition of costs.…”

Section: Discussionmentioning

confidence: 99%

Economic Burden of Psoriasis and Potential Cost Offsets with Biologic Treatment: A Swedish Register Analysis

Svedbom¹,

Dahlén²,

Mamolo³

et al. 2016

Acta Derm Venerol

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Estimates of direct and indirect costs of psoriasis are limited. The aim of this study was to estimate: (i) costs in patients with psoriasis compared with controls; and (ii) impact on costs from initiating biologics. The study extracted data from Swedish administrative registers and compared 31,043 patients with 111,645 sex-, age- and residency-matched referents. Mean direct and indirect costs were estimated as US dollars (USD) 1,365 (62%) and USD 3,319 (50%) higher in patients compared with referents, respectively. The study included 352 patients treated with biologics who had at least 1-year follow-up before and after initiation of biologics. Among the 193 patients persistent with biologics for one year, 1-year costs of biologics were estimated at USD 23,293 (95% confidence interval (95% CI) 22,372-24,199). This cost was partially offset, with savings in direct cost estimated to range from USD -1135 (95% CI -2,050 to -328) to USD -4,422 (95% CI -6,552 to -2,771), depending on assumptions. The corresponding estimates for indirect costs savings were from USD -774 (95% CI -2,019-535) to USD -1,875 (95% CI -3,650 to -188). The study suggests that psoriasis is associated with substantial costs, which may be modifiable with treatment.

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Section: Discussionmentioning

confidence: 99%

Economic Burden of Psoriasis and Potential Cost Offsets with Biologic Treatment: A Swedish Register Analysis

Svedbom¹,

Dahlén²,

Mamolo³

et al. 2016

Acta Derm Venerol

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“…methotrexate) or phototherapy may be indicated in patients who do not respond to the first-line topical therapy (5). Methotrexate is the most commonly prescribed systemic agent for psoriasis in Sweden (7).…”

mentioning

confidence: 99%

A Cost-utility Analysis of Calcipotriol/Betamethasone Dipropionate Aerosol Foam versus Ointment for the Topical Treatment of Psoriasis Vulgaris in Sweden

Duvetorp

Levin²,

Mattsson³

et al. 2019

Acta Derm Venerol

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Psoriasis is a chronic heterogenous disorder with a substantial impact on patients and healthcare systems. We evaluated the cost-effectiveness of Cal/BD foam versus Cal/ BD ointment over a 12-week time horizon in patients with psoriasis, from a Swedish healthcare perspective. In our model, the superior efficacy of Cal/BD foam over ointment led to fewer consultation visits, a decreased risk of progressing to second-line therapy, and lower total costs. Improved topical therapies, such as Cal/BD foam, have the potential to reduce the need for some patients to progress to phototherapy and/or systemic treatment, which may lead to a reduction in the overall treatment costs of psoriasis. Psoriasis is a chronic inflammatory disorder that imposes a substantial economic burden. We conducted a cost-utility analysis from a Swedish healthcare payer's perspective using a decision-tree model with a 12week time horizon. Patients with psoriasis vulgaris could have two 4-week cycles of topical treatment with calcipotriol 50 µg/g and betamethasone 0.5 mg/g as dipropionate (Cal/BD) foam or Cal/BD ointment before progressing to phototherapy/methotrexate. In the base-case analysis, Cal/BD foam dominated over Cal/BD ointment. The increased efficacy of Cal/BD foam resulted in fewer consultations and a decreased risk of progressing to phototherapy/methotrexate. Although Cal/BD foam costs more than Cal/BD ointment, this was offset by lower costs for phototherapy/ methotrexate or consultation visits. Sensitivity analyses revealed that the base-case net monetary benefit was robust to plausible variations in key parameters. In conclusion, Cal/BD foam was predicted to be more cost-effective than Cal/BD ointment in the treatment of psoriasis vulgaris.

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“…With improved overall health, patients on biologic therapy can often improve their productivity, reduce their disability, and reduce their need for outpatient care ( Kimball et al, 2012 ; Larsen et al, 2013 ; Reich et al, 2011 ), which can have a substantial positive economic impact. For example, a recent Swedish study found that, although initiating treatment with a biologic increased the direct costs of managing psoriasis, the economic benefits of increased productivity, including reduced long-term sick leave and disability pension payments, significantly outweighed the increased direct costs ( Norlin, Steen Carlsson, Persson, & Schmitt-Egenolf, 2015 ). Such findings highlight the importance of communicating openly with patients to weigh the benefits versus costs of available treatments.…”

Section: Special Considerations For Patient Care and Helpful Tipsmentioning

confidence: 99%

Providing Guidance for Patients With Moderate-to-Severe Psoriasis Who are Candidates for Biologic Therapy

Aldredge

Young

2018

Journal of the Dermatology Nurses' Association

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Psoriasis is a chronic, immune-mediated disease characterized by itchy, scaly, and often painful plaques in the skin. Psoriasis can have significant psychosocial burdens and increased risks for numerous comorbidities, including diabetes, hypertension, and cardiovascular disease, particularly in patients with moderate-to-severe disease. Dermatology nurse practitioners and physician assistants are an important part of the healthcare team, contributing to all aspects of psoriasis management. This review reinforces the unique aspects of care that nurse practitioners and physician assistants provide to patients with psoriasis, such as facilitating conversations about managing disease, setting appropriate expectations, and considering treatment options, including when treatment response or tolerability is suboptimal. The importance of relationship building is stressed. Patient management topics discussed include helpful tips about assessing treatment options, initiating biologic therapy, optimizing patient adherence, and managing comorbidities. Also reviewed are how to deal with common barriers including lack of knowledge about psoriasis or making healthy lifestyle changes, fear of injections or side effect risks, lack of health insurance, and concerns about treatment costs. Overall, by forming meaningful relationships and engaging patients in their psoriasis care, nurse practitioners and physician assistants can help to optimize clinical efficacy outcomes and consistently manage moderate-to-severe psoriasis and its comorbidities over the patient’s life course.

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Resource Use in Patients with Psoriasis After the Introduction of Biologics in Sweden

Cited by 14 publications

References 29 publications

Economic Burden of Psoriasis and Potential Cost Offsets with Biologic Treatment: A Swedish Register Analysis

Economic Burden of Psoriasis and Potential Cost Offsets with Biologic Treatment: A Swedish Register Analysis

A Cost-utility Analysis of Calcipotriol/Betamethasone Dipropionate Aerosol Foam versus Ointment for the Topical Treatment of Psoriasis Vulgaris in Sweden

Providing Guidance for Patients With Moderate-to-Severe Psoriasis Who are Candidates for Biologic Therapy

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