Poster Recap: Associations Among Opioid Use, Outpatient Visits, and Comorbidities in Patients With Moderate-to-Severe Psoriasis

Background

Zhdanava and colleagues conducted a retrospective study to examine how patients with moderate-to-severe plaque psoriasis (PsO) typically use opioids and healthcare resources; these patients were stratified by number of PsO-related comorbidities.¹

Methods

Gathering data (dated between January 2010 and March 2017) from a database of privately insured patients, Zhdanava and colleagues identified adults with moderate-to-severe PsO who had 2 or more diagnoses. The date of the first diagnosis was considered the index date. Patients receiving systemic or biologic therapeutics were stratified by the number of PsO-related comorbidities that began within 12 months after the index date. Per-patient-per-year (PPPY) outpatient visits were tracked after the index date until patient eligibility ended or the data were no longer available.¹

Patients with less than 12 months coverage before or after the index date or with pre-existing PsO-related comorbidities were not included in the study.¹

Results

During the 12 months before the index date, more PsO patients (24.2% of the systemic users and 26.9% of the biologic users) received opioids than non-PsO patients (15.7%). For PsO patients, during the pre-index period, a greater number of comorbidities was associated with increased opioid use. Of systemic users with 0 comorbidities, 21.3% used opioids; with 1 to 2 comorbidities, 27.8%; and with 3 or more, 31.4%. Of biologic users with 0 comorbidities, 21.7% used opioids; with 1 to 2 comorbidities, 32.2%; and with 3 or more, 33.3%.¹

After the index date, of the systemic users, 58.8% developed 0 comorbidities, 35.4% developed 1 to 2, and 5.8% developed 3 or more. Of the biologic users, 51.3% developed 0 comorbidities, 40.2% developed 1 to 2, and 8.5% developed 3 or more. A greater number of comorbidities was associated with more PPPY outpatient visits. For systemic users with 0 comorbidities, the PPPY outpatient visit rate was 12.7; 1 to 2 comorbidities, 16.4; and 3 or more comorbidities, 24.2. For biologic users with 0 comorbidities, the PPPY outpatient visit rate was 10.4; 1 to 2 comorbidities, 14.5; and 3 or more comorbidities, 22.5.¹

Before and after the index date, opioid treatment was associated with higher PPPY outpatient visit rates. For systemic users who received opioids and had 0 comorbidities, the PPPY outpatient visit rate was 14.2; 1 to 2 comorbidities, 18.8; and 3 or more comorbidities, 26.7. For biologic users who received opioids and had 0 comorbidities, the PPPY outpatient visit rate was 11.5; 1 to 2 comorbidities, 18.1; and 3 or more comorbidities, 26.4.¹

Conclusions

The results of this analysis showed that patients with moderate-to-severe PsO had a high rate of opioid use, and this rate increased with the number of PsO-related comorbidities. Opioid use and/or a higher number of comorbidities was associated with a higher number of PPPY outpatient visits.¹

Reference

1. Zhdanava M, Teeple A, Pilon D, Shak N, Fitzgerald T, Lefebvre P. Opioid and healthcare resource use among privately insured moderate-to-severe psoriasis patients in the US. Poster presented at: ISPOR 2019; May 18-22, 2019; New Orleans, LA. ispor.org/heor-resources/presentations-database/presentation/intl2019-2217/92246.