title: Healthcare Resource Use and Direct Costs in Patients with Ankylosing Spondylitis and Psoriatic Arthritis in a Large US Cohort.
abstract: OBJECTIVE
  Direct costs of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) have not been well characterized in the United States. This study assessed healthcare resource use and direct cost of AS and PsA, and identified predictors of all-cause medical and pharmacy costs.
  
  
  METHODS
  Adults aged ≥ 18 with a diagnosis of AS and PsA were identified in the MarketScan databases between October 1, 2011, and September 30, 2012. Patients were continuously enrolled with medical and pharmacy benefits for 12 months before and after the index date (first diagnosis). Baseline demographics and comorbidities were identified. Direct costs included hospitalizations, emergency room and office visits, and pharmacy costs. Multivariable regression was used to determine whether baseline covariates were associated with direct costs.
  
  
  RESULTS
  Patients with AS were younger and mostly men compared with patients with PsA. Hypertension and hyperlipidemia were the most common comorbidities in both cohorts. A higher percentage of patients with PsA used biologics and nonbiologic disease-modifying drugs (61.1% and 52.4%, respectively) compared with patients with AS (52.5% and 21.8%, respectively). Office visits were the most commonly used resource by patients with AS and PsA (∼11 visits). Annual direct medical costs [all US dollars, mean (SD)] for patients with AS and PsA were $6514 ($32,982) and $5108 ($22,258), respectively. Prescription drug costs were higher for patients with PsA [$14,174 ($15,821)] compared with patients with AS [$11,214 ($14,249)]. Multivariable regression analysis showed higher all-cause direct costs were associated with biologic use, age, and increased comorbidities in patients with AS or PsA (all p < 0.05).
  
  
  CONCLUSIONS
  Biologic use, age, and comorbidities were major determinants of all-cause direct costs in patients with AS and PsA.
authors.affiliation: From the Department of Rheumatology, New York University School of Medicine, New York, New York; Health Economics and Outcomes Research, and Outcomes Research Methods and Analytics, US Health Economics and Outcomes Research, Novartis Pharmaceuticals Corp., East Hanover; KMK Consulting Inc., Florham Park, New Jersey; Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.J.D. Greenberg, MD, MPH, New York University Hospital for Joint Disease, and Department of Rheumatology, New York University School of Medicine; J.B. Palmer, PharmD, Health Economics and Outcomes Research, Novartis; Y. Li, PhD, Outcomes Research Methods and Analytics, US Health Economics & Outcomes Research, Novartis; V. Herrera, PharmD, Health Economics and Outcomes Research, Novartis; Y. Tsang, PharmD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy; M. Liao, MA, KMK Consulting Inc. JGreenberg@corrona.org.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Greenberg
authors.affiliation: From the Department of Rheumatology, New York University School of Medicine, New York, New York; Health Economics and Outcomes Research, and Outcomes Research Methods and Analytics, US Health Economics and Outcomes Research, Novartis Pharmaceuticals Corp., East Hanover; KMK Consulting Inc., Florham Park, New Jersey; Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.J.D. Greenberg, MD, MPH, New York University Hospital for Joint Disease, and Department of Rheumatology, New York University School of Medicine; J.B. Palmer, PharmD, Health Economics and Outcomes Research, Novartis; Y. Li, PhD, Outcomes Research Methods and Analytics, US Health Economics & Outcomes Research, Novartis; V. Herrera, PharmD, Health Economics and Outcomes Research, Novartis; Y. Tsang, PharmD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy; M. Liao, MA, KMK Consulting Inc.
authors.forename: Jacqueline B
authors.initials: JB
authors.lastname: Palmer
authors.affiliation: From the Department of Rheumatology, New York University School of Medicine, New York, New York; Health Economics and Outcomes Research, and Outcomes Research Methods and Analytics, US Health Economics and Outcomes Research, Novartis Pharmaceuticals Corp., East Hanover; KMK Consulting Inc., Florham Park, New Jersey; Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.J.D. Greenberg, MD, MPH, New York University Hospital for Joint Disease, and Department of Rheumatology, New York University School of Medicine; J.B. Palmer, PharmD, Health Economics and Outcomes Research, Novartis; Y. Li, PhD, Outcomes Research Methods and Analytics, US Health Economics & Outcomes Research, Novartis; V. Herrera, PharmD, Health Economics and Outcomes Research, Novartis; Y. Tsang, PharmD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy; M. Liao, MA, KMK Consulting Inc.
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Li
authors.affiliation: From the Department of Rheumatology, New York University School of Medicine, New York, New York; Health Economics and Outcomes Research, and Outcomes Research Methods and Analytics, US Health Economics and Outcomes Research, Novartis Pharmaceuticals Corp., East Hanover; KMK Consulting Inc., Florham Park, New Jersey; Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.J.D. Greenberg, MD, MPH, New York University Hospital for Joint Disease, and Department of Rheumatology, New York University School of Medicine; J.B. Palmer, PharmD, Health Economics and Outcomes Research, Novartis; Y. Li, PhD, Outcomes Research Methods and Analytics, US Health Economics & Outcomes Research, Novartis; V. Herrera, PharmD, Health Economics and Outcomes Research, Novartis; Y. Tsang, PharmD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy; M. Liao, MA, KMK Consulting Inc.
authors.forename: Vivian
authors.initials: V
authors.lastname: Herrera
authors.affiliation: From the Department of Rheumatology, New York University School of Medicine, New York, New York; Health Economics and Outcomes Research, and Outcomes Research Methods and Analytics, US Health Economics and Outcomes Research, Novartis Pharmaceuticals Corp., East Hanover; KMK Consulting Inc., Florham Park, New Jersey; Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.J.D. Greenberg, MD, MPH, New York University Hospital for Joint Disease, and Department of Rheumatology, New York University School of Medicine; J.B. Palmer, PharmD, Health Economics and Outcomes Research, Novartis; Y. Li, PhD, Outcomes Research Methods and Analytics, US Health Economics & Outcomes Research, Novartis; V. Herrera, PharmD, Health Economics and Outcomes Research, Novartis; Y. Tsang, PharmD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy; M. Liao, MA, KMK Consulting Inc.
authors.forename: Yuen
authors.initials: Y
authors.lastname: Tsang
authors.affiliation: From the Department of Rheumatology, New York University School of Medicine, New York, New York; Health Economics and Outcomes Research, and Outcomes Research Methods and Analytics, US Health Economics and Outcomes Research, Novartis Pharmaceuticals Corp., East Hanover; KMK Consulting Inc., Florham Park, New Jersey; Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.J.D. Greenberg, MD, MPH, New York University Hospital for Joint Disease, and Department of Rheumatology, New York University School of Medicine; J.B. Palmer, PharmD, Health Economics and Outcomes Research, Novartis; Y. Li, PhD, Outcomes Research Methods and Analytics, US Health Economics & Outcomes Research, Novartis; V. Herrera, PharmD, Health Economics and Outcomes Research, Novartis; Y. Tsang, PharmD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy; M. Liao, MA, KMK Consulting Inc.
authors.forename: Minlei
authors.initials: M
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics*; D001688:Biological Products / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D004180:Direct Service Costs; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics*; D014481:United States; D055815:Young Adult
chemical_list: D001688:Biological Products
keywords: ANKYLOSING SPONDYLITIS; COST ANALYSIS; MEDICAL CARE COSTS; OBSERVATIONAL STUDY; PRESCRIPTION DRUGS; PSORIATIC ARTHRITIS