Using a single product (calcipotriene/betamethasone topical suspension) vs multiple products to manage body and scalp psoriasis: comparisons in resource utilization and costs.
OBJECTIVE
To compare resource utilization and costs among patients who used calcipotriene/betamethasone dipropionate topical suspension (Taclonex Scalp Topical Suspension, Leo Pharma A/S) vs those who used multiple body and scalp formulations for psoriasis.


METHODS
A retrospective study using Truven Health MarketScan Commercial Database from 2006-2011 was performed to identify patients with psoriasis (ICD code 696.1x). Two study cohorts analyzed were cohort A (used body-only formulations for psoriasis and switched on the index date to using calcipotriene/betamethasone dipropionate topical suspension alone) and cohort B (used multiple body and scalp formulations for psoriasis). Patients were required to be continuously enrolled during 180-days pre- and post-index periods. Multiple regression analyses adjusting for baseline demographic and clinical covariates were performed.


METHODS
Number of psoriasis-related outpatient visits, total healthcare costs, psoriasis-related costs, and use of systemic agents during post-index period.


RESULTS
A total of 1923 patients were identified with at least one prescription for calcipotriene/betamethasone dipropionate scalp topical suspension (cohort A = 367, cohort B = 1556). Patients using multiple medications (cohort B) were associated with 48% higher number of outpatient visits as compared with those who used a single formulation (cohort A) after controlling for baseline covariates (p < 0.001). A generalized linear model adjusting for baseline covariates showed significantly higher post-index total and psoriasis-related healthcare costs for cohort B as compared with cohort A (both p < 0.001). Patients in Cohort B also had twice the odds of using systemic agents as compared to patients in Cohort A (p < 0.001).


CONCLUSIONS
Patients with body and scalp psoriasis using a single product had significantly lower overall and psoriasis-related healthcare costs, needed fewer psoriasis-related outpatient visits, and used less systemic agents during the post-index period. A lack of robust clinical measures to define the disease severity may have limited the interpretations from this study.
Wake Forest Baptist Medical Center , Winston-Salem, NC , USA.
Steven R
SR
Feldman
Eugenia
E
Levi
Prathamesh
P
Pathak
Sonali
S
Kakatkar
Rajesh
R
Balkrishnan
D000293:Adolescent; D000328:Adult; D001623:Betamethasone / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000191:economics* / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics; D012189:Retrospective Studies; D012536:Scalp Dermatoses / Q000188:drug therapy* / Q000191:economics; D055815:Young Adult
D003879:Dermatologic Agents; D004338:Drug Combinations; C517164:betamethasone dipropionate, calcipotriol drug combination; D001623:Betamethasone; D002117:Calcitriol