Medication adherence and health care costs associated with biologics in Medicaid-enrolled patients with psoriasis.
BACKGROUND
Costs and patients' adherence related to biologics are important factors to consider while making informed decisions regarding therapy with biologics in psoriasis management.


OBJECTIVE
To examine predictors of adherence related to biologics, total health care costs, and service utilization among psoriasis patients.


METHODS
This was a longitudinal cohort study of psoriasis patients (<65 years old) enrolled in North Carolina Medicaid who were prescribed biologics (alefacept, efalizumab, and etanercept). Patients' medication adherence, health care costs, and service utilization patterns in the pre- and post-biologics period were examined.


RESULTS
Adherence to biologics was significantly higher compared with the other psoriasis medications (0.66 vs 0.39; p<0.001). Prescription costs were significantly higher in the post-biologics period (3796.77 US dollars vs 11,706.32 US dollars; p<0.001). However, total health care costs in the post-biologics period did not differ significantly from the pre-biologics period (14,662.22 US dollars vs 16,156.10 US dollars; p>0.05). Patients' adherence and health care costs did not differ significantly across the biologics. After controlling for other variables, patients had a significantly lower number of hospitalizations in the post-biologics period (p<0.001).


CONCLUSIONS
Although costs associated with prescriptions for biologics were higher, total health care costs did not differ significantly in the post-biologics period. Biologics had a better adherence rate compared with other psoriasis medications.
Bhosle
Monali J
MJ
Division of Pharmacy Practice and Administration, The Ohio State University College of Pharmacy, Columbus, OH 43210, USA.
Feldman
Steven R
SR
Camacho
Fablan T
FT
Timothy Whitmire
J
J
Nahata
Milap C
MC
Balkrishnan
Rajesh
R
D000328:Adult; D001688:Biological Products / Q000008:administration & dosage* / Q000191:economics*; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D010349:Patient Compliance; D011565:Psoriasis / Q000191:economics / Q000628:therapy*; D014481:United States
D001688:Biological Products