Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis

Wu, Jashin J.; Pelletier, Corey; Ung, Brian; Tian, Marc; Khilfeh, Ibrahim; Curtis, Jeffrey R.

doi:10.1007/s12325-020-01262-9

Cited by 8 publications

(8 citation statements)

References 39 publications

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“…Switching rates found in the current study are also generally consistent with those reported in the literature 15,18 . In a recent study by Wu et al, assessing treatment patterns in PsA patients treated with bDMARDs (TNFi and non-TNFi) versus apremilast, authors reported a 33.3% switching rate at 2 years after treatment initiation in the bDMARDs cohort 15 the switching rate among PsA patients was 32.3% at 2 years in the current study. Similarly, the one year switching rate found in the current study among the subsample of RA patients (21.9%) is also generally in line with the rates reported in the literature, ranging between 11 and 18%, although closer to the upper end of the spectrum [19][20][21] .…”

Section: Discussionsupporting

confidence: 92%

“…However, the high proportion of RA and PsA patients initiating first-line advanced treatment on adalimumab and etanercept is consistent with the literature. Adalimumab and etanercept are well-established TNFi and generally reported as the most common treatments initiated among patients starting advanced treatments [14][15][16][17] . Switching rates found in the current study are also generally consistent with those reported in the literature 15,18 .…”

Section: Discussionmentioning

confidence: 99%

“…Adalimumab and etanercept are well-established TNFi and generally reported as the most common treatments initiated among patients starting advanced treatments [14][15][16][17] . Switching rates found in the current study are also generally consistent with those reported in the literature 15,18 . In a recent study by Wu et al, assessing treatment patterns in PsA patients treated with bDMARDs (TNFi and non-TNFi) versus apremilast, authors reported a 33.3% switching rate at 2 years after treatment initiation in the bDMARDs cohort 15 the switching rate among PsA patients was 32.3% at 2 years in the current study.…”

Section: Discussionmentioning

confidence: 99%

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Treatment patterns and sequencing in patients with rheumatic diseases: a retrospective claims data analysis

Gauthier

Levin

Vekeman

et al. 2021

Current Medical Research and Opinion

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Objectives: Long-term real-world management of inflammatory rheumatic diseases remains unclear, especially with the advent of new treatment options. This study characterizes the number of advanced treatments used by patients with selected rheumatic diseases (rheumatoid arthritis [RA], psoriatic arthritis [PsA], ankylosing spondylitis, juvenile idiopathic arthritis) and provides a contemporary portrait of treatment patterns and therapeutic sequencing among patients with RA and PsA. Method: Patients were selected from a large US claims database and classified into disease subsamples based on the latest rheumatic diagnosis recorded before/on the day of initiation of the first advanced treatment (index date). The total number of advanced treatments was assessed within the first 5 years following the index date. Treatment patterns and therapeutic sequencing were assessed over the first 2 years. Results: Approximately 20% of patients received !2 distinct advanced treatments during the first year following index datethe proportion increased to almost 50% among patients with 5 years of observation. Most patients (RA: 76.8%; PsA: 88.7%) initiated a tumor necrosis factor as the first advanced treatment. Over the first 2 years after the index date, 1/3 of RA and PsA patients switched to another advanced treatment. More than 50% initiated a second treatment with the same mechanism of action (MOA). A small proportion of patients received a biosimilar. Conclusion: Despite advent of treatments with different MOA, cycling between treatments with the same MOA was common. Further studies with longer data follow-up would be needed to assess the impact of higher adoption of biosimilars on treatment patterns/sequencing.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Treatment patterns and sequencing in patients with rheumatic diseases: a retrospective claims data analysis

Gauthier

Levin

Vekeman

et al. 2021

Current Medical Research and Opinion

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“…Cancer-related treatments include antineoplastic agents, adjunctive therapies, and any other US Federal Drug Administration (FDA)-approved treatment for conditions caused by cancer or its treatment [ 24 ]. The costs utilized in this analysis reflects standardized costs calculated based on a proprietary Optum algorithm that reflects adjustment of allowable payment amounts sourced from the claim forms to estimate standardized costs that reduce potential local/regional or payer/plan differences across individual hospitals and providers and enable national normalization of costs for better comparison across patients, data sources, and geographic regions [ 25 – 27 ]. All dollar estimates were inflated to 2020 dollars using an Optum-provided inflation factor based on the Medical Care Component of the Consumer Price Index (CPI).…”

Section: Methodsmentioning

confidence: 99%

Increased healthcare costs by later stage cancer diagnosis

McGarvey¹,

Gitlin²,

Fadli³

et al. 2022

BMC Health Serv Res

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Background Cancer represents a significant source of disease burden in the United States (US), both clinically and economically. Diagnosis and treatment of cancer at earlier stages may reduce this burden. To better understand potential impacts of earlier diagnosis, healthcare costs among patients with cancer were assessed by cancer type and stage at diagnosis. Methods A retrospective analysis was conducted using Optum’s de-identified Integrated Claims-Clinical data set with Enriched Oncology, which includes data from Medicare Advantage and commercially insured members. Adult members newly diagnosed with solid tumor cancers, cancer stage at diagnosis (diagnosed 1/1/2016–6/30/2020), and continuous enrollment for at least one month post diagnosis were identified. Patients with breast, cervical, colorectal, lung, ovarian, or prostate cancer were reported. Mean standardized costs (2020 USD) were calculated in each month on an annual and cumulative basis through four years post-cancer diagnosis. In each month, costs were calculated for those with continuous enrollment and no death reported in the month. Mean annual cost per patient was estimated by summing month one to 12 mean costs and stratifying by stage at cancer diagnosis; annual year one to four costs were summed to determine cumulative costs. Results Among members diagnosed 2016–2020 with breast, cervical, colorectal, lung, ovarian, or prostate cancer, 20,422 eligible members were identified. Mean costs increased by stage of diagnosis across all cancers at the annual and cumulative level through year four post diagnosis. Cumulative mean costs grew over time at a relatively similar rate across stages I to III and more dramatically in stage IV, except for cervical and lung cancer where the rate was relatively stable or slightly fluctuated across stages and ovarian cancer where stages III and IV both increased more sharply compared to stages I and II. Conclusions Mean annual and cumulative healthcare costs through year four post cancer diagnosis were significantly higher among those diagnosed at later versus earlier cancer stages. The steeper increase in cumulative costs among those diagnosed in stage IV for many cancer types highlights the importance of earlier cancer diagnosis. Earlier cancer diagnosis may enable more efficient treatment, improve patient outcomes and reduce healthcare costs.

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“…A substantial proportion of patients with PsA are inadequately treated with currently available therapeutic options; many of these medications have safety concerns and have inconvenient dosing, and few patients reach treatment targets, such as achievement of minimal disease activity (MDA). This results in disease progression and disability, frequent medication switching, and higher overall treatment costs 5 6. Therapies with new modes of action that are safe, effective and have convenient dosing are needed to control the spectrum of disease manifestations and improve the quality of life of patients with PsA as another option for treatment, including in those who do not respond to other modalities 7 8…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of selective TYK2 inhibitor, deucravacitinib, in a phase II trial in psoriatic arthritis

et al. 2022

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ObjectiveTo evaluate the efficacy and safety of an oral selective tyrosine kinase 2 (TYK2) inhibitor, deucravacitinib, in patients with active psoriatic arthritis (PsA).MethodsIn this double-blind, phase II trial, 203 patients with PsA were randomised 1:1:1 to placebo, deucravacitinib 6 mg once a day or 12 mg once a day. The primary endpoint was American College of Rheumatology-20 (ACR-20) response at week 16.ResultsACR-20 response was significantly higher with deucravacitinib 6 mg once a day (52.9%, p=0.0134) and 12 mg once a day (62.7%, p=0.0004) versus placebo (31.8%) at week 16. Both deucravacitinib doses resulted in significant improvements versus placebo (p≤0.05) in the multiplicity-controlled secondary endpoints of change from baseline in Health Assessment Questionnaire-Disability Index and Short Form-36 Physical Component Summary score and in Psoriasis Area and Severity Index-75 response. Improvements were also seen in multiple exploratory endpoints with deucravacitinib treatment. The most common adverse events (AEs) (≥5%) in deucravacitinib-treated patients were nasopharyngitis, upper respiratory tract infection, sinusitis, bronchitis, rash, headache and diarrhoea. There were no serious AEs and no occurrence of herpes zoster, opportunistic infections and major adverse cardiovascular events, or differences versus placebo in mean changes in laboratory parameters with deucravacitinib treatment.ConclusionsTreatment with the selective TYK2 inhibitor deucravacitinib was well tolerated and resulted in greater improvements than placebo in ACR-20, multiplicity-controlled secondary endpoints and other exploratory efficacy measures in patients with PsA. Larger trials over longer periods of time with deucravacitinib are warranted to confirm its safety profile and benefits in PsA.Trial registration numberNCT03881059.

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Treatment Switch Patterns and Healthcare Costs in Biologic-Naive Patients with Psoriatic Arthritis

Cited by 8 publications

References 39 publications

Treatment patterns and sequencing in patients with rheumatic diseases: a retrospective claims data analysis

Treatment patterns and sequencing in patients with rheumatic diseases: a retrospective claims data analysis

Increased healthcare costs by later stage cancer diagnosis

Efficacy and safety of selective TYK2 inhibitor, deucravacitinib, in a phase II trial in psoriatic arthritis

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