Psoriatic Arthritis Leads to Higher Costs, Absenteeism, Studies Say

May 23, 2020

Psoriatic arthritis and psoriasis both place a significant economic burden on patients, but a new analysis shows the burden on people with the former is significantly higher.

Patients with psoriatic arthritis (PsA) have far higher health care costs than patients with psoriasis (PsO), and both groups have substantially higher costs than a control group without either diagnosis, according to new research.

In an abstract presented at the Virtual ISPOR 2020 meeting, corresponding author Joseph Merola, MD, of Brigham and Women’s Hospital, in Boston, and colleagues report on what they found when they analyzed the IBM MarketScan Commercial Database for records of adult patients between the years of 2009 and 2019. The authors identified 3 groups for study: patients who had 1 or more inpatient diagnosis or 2 outpatient diagnoses for PsO; patients who had 1 inpatient or 2 outpatient diagnoses for PsA; and a control group without diagnoses of either PsO or PsA.

All told, the data yielded 204,062 patients in the PsO group, 33,145 patients in the PsA group, and 237,207 people in the control group.

Merola and colleagues found that patients with PsO had annual all-cause health care costs averaging $11,695 versus $8485 for the control group. However, patients with PsA had all-cause health care costs that were more than triple that of the control group: $26,393 per year.

When the investigators looked specifically at outpatient pharmacy costs, they found prescriptions accounted for 19% of the control group’s annual health care spending, 34% of the PsO group’s spending, and more than half (53%) of the PsA group’s spending. Patients with PsA also had the highest use of health care resources of any group. This category included services such as physician office visits, hospitalizations, and outpatient services.

“A diagnosis of PsA is associated with significantly higher healthcare utilization and costs than patients without PsO and PsA diagnosis,” Merola and colleagues said. “And these costs increase over time.”

A similar ISPOR study demonstrated another way these diseases affect the lives of patients. Corresponding author Ana-Maria Orbai, MD, MHS, of the Johns Hopkins Arthritis Center, and colleagues looked at rates of work absenteeism and disability in patients with PsA and PsO. Using the same database and qualifiers as Merola’s study, the investigators found higher rates of both absenteeism and short-term disability among patients with PsA and PsO.

In Orbai’s study, the average costs from non-recreational work absences were $1901 per patient per year in the PsA group; $1649 per patient per year in the PsO group; and $1427 per patient per year in the control group. The authors found that the odds of a patient needing to go on short-term disability were significantly higher if the patient had PsA, and that the average per-patient-per-year costs of short-term disability were $654 for PsA, $444 for PsO, $349 for the control group.

The authors noted that the available data did not allow an analysis of potential confounding factors, such as disease severity or alcohol or tobacco abuse. Still, they said the data suggest improvements in therapies for these conditions could have economic benefits.

“Effective treatments and medical care could help improve disease control and reduce work disability costs for employers,” Orbai and colleagues conclude.

References

1. Merola J, Peterson S, Dennis N, et al. Retrospective study examining health care utilization and costs for patients with psoriasis and psoriatic arthritis in the US. Presented at: ISPOR 2020; May 18-20, 2020; PMU15.

2. Orbai AM, Reddy S, Villacorta R, et al. Absenteeism and work disability associated with psoriasis and psoriatic arthritis in the US. Presented at: ISPOR 2020; May 18-20, 2020; PMU31.