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Direct healthcare costs and comorbidity burden among patients with psoriatic arthritis in the USA

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Abstract

This study assessed the comorbidity burden and direct healthcare costs associated with psoriatic arthritis (PsA). Adults (18–64 years) with ≥ 2 claims for a PsA diagnosis ≥ 30 days apart in the Truven Health MarketScan database (July 2009–June 2014) were selected as the case group. The index date was randomly selected after the first claim for PsA. Controls free of PsA and psoriasis (PsO) in their entire claims history were assigned the same index date and were matched with the cases on age, gender, and geographic region. All patients had ≥ 12 months of continuous eligibility before and after (study period) the index date. PsA-associated comorbidities, medication use, and medical service utilization were compared between matched groups using Wilcoxon signed rank and McNemar’s tests. Costs were compared using multivariable generalized linear models. The 35,061 matched pairs had a mean age of 49.11 ± 10.20 years and 52.73% were female. During the study period, PsA patients had more PsA-associated comorbidities and significantly higher medication use than controls (all-cause medications 96.64 vs. 78.95%, p < 0.0001). PsA patients had significantly greater medical service use (inpatient admissions, hospitalization days, emergency room visits, outpatient services; all p < 0.0001) and higher annual direct healthcare costs per patient than controls (adjusted cost difference [ACD] = $18,482, including higher medical costs [ACD = $6440] and all-cause pharmacy costs [ACD = $11,737]; all p < 0.0001). Overall, PsA patients had a significantly higher PsA-related comorbidity burden, healthcare utilization, and direct healthcare costs than people free of PsA and PsO, underscoring the need for more effective treatments and improved care delivery systems.

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Acknowledgments

We would like to thank Peter Hur, an employee of Novartis Pharmaceutical Corporation, for his help with the manuscript.

Funding

Funding for this research was provided by Novartis Pharmaceutical Corporation.

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Authors and Affiliations

  1. Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Joseph F. Merola

  2. Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA

    Vivian Herrera & Jacqueline B. Palmer

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Correspondence to Joseph F. Merola.

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Conflict of interest

Vivian Herrera is an employee of Novartis Pharmaceutical Corporation and owns stock/stock options. Jacqueline B. Palmer is an employee of Novartis Pharmaceutical Corporation. Dr. Merola received funding support from the following corporate entities in the biotechnology/pharmaceutical sector: Biogen IDEC (research investigator funding, research grant, advisor board fees, consultant fees); AbbVie (Speaker fees, advisory board fees, licensed outcome measures funding); Amgen (advisor board fees, research investigator funding); Eli Lilly (advisor board fees, consultant fees); Novartis (advisor board fees, consultant fees); Pfizer (research investigator funding); Janssen (advisory board fees); and Momenta (consultant fees).

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Merola, J.F., Herrera, V. & Palmer, J.B. Direct healthcare costs and comorbidity burden among patients with psoriatic arthritis in the USA. Clin Rheumatol 37, 2751–2761 (2018). https://doi.org/10.1007/s10067-018-4187-y

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