title: Psoriasis in the US Medicare Population: Prevalence, Treatment, and Factors Associated with Biologic Use.
abstract: Psoriasis is a common chronic inflammatory disorder, primarily of the skin. Despite an aging population, knowledge of the epidemiology of psoriasis and its treatments among the elderly is limited. We examined the prevalence of psoriasis and its treatments, with a focus on biologics and identification of factors associated with biologic use, using a nationally representative sample of Medicare beneficiaries in 2011. On the basis of several psoriasis identification algorithms, the claims-based prevalence for psoriasis in the United States ranged from 0.51 to 1.23%. Treatments used for moderate-to-severe psoriasis (phototherapy, oral systemic, or biologic therapies) were received by 27.3% of the total psoriasis sample, of whom 37.2% used biologics. Patients without a Medicare Part D low-income subsidy (LIS) had 70% lower odds of having received biologics than those with LIS (odds ratio 0.30; 95% confidence interval, 0.19-0.46). Similarly, the odds of having received biologics were 69% lower among black patients compared with white patients (0.31; 0.16-0.60). This analysis identified potential financial and racial barriers to receipt of biologic therapies and underscores the need for additional studies to further define the epidemiology and treatment of psoriasis among the elderly.
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. Electronic address: Junko.Takeshita@uphs.upenn.edu.
authors.forename: Junko
authors.initials: J
authors.lastname: Takeshita
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gelfand
authors.affiliation: Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Penxiang
authors.initials: P
authors.lastname: Li
authors.affiliation: Amgen, Thousand Oaks, California, USA.
authors.forename: Lionel
authors.initials: L
authors.lastname: Pinto
authors.affiliation: Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Xinyan
authors.initials: X
authors.lastname: Yu
authors.affiliation: Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Health Care Management and Economics, The Wharton School at University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Preethi
authors.initials: P
authors.lastname: Rao
authors.affiliation: Amgen, Thousand Oaks, California, USA.
authors.forename: Hema N
authors.initials: HN
authors.lastname: Viswanathan
authors.affiliation: Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Jalpa A
authors.initials: JA
authors.lastname: Doshi
mesh_terms: D000368:Aged; D001688:Biological Products / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare; D015995:Prevalence; D011565:Psoriasis / Q000188:drug therapy / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
chemical_list: D001688:Biological Products