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Cost of care for patients with AS, PsA may be related to biologics, age, comorbidities
All-cause, direct costs of care for patients with ankylosing spondylitis and psoriatic arthritis were most closely associated with the use of biologic medication, patient age and comorbidities, according to recently published research.
Researchers performed a retrospective, observational claims analysis of 4,288 patients with ankylosing spondylitis (AS) and 10,832 patients with psoriatic arthritis (PsA) who had information entered in the Truven Health Analytics MarketScan Research databases. Researchers collected inpatient and outpatient data for health care services related to cost, use and outcomes. Eligible adult patients with at least two claims for AS or PsA were continuously enrolled for both medical and pharmacy benefits, and an index date was designated for each patient at the time of diagnosis.
The mean age of patients was 49.1 years in the AS group and 51.9 years in the PsA group. About half of patients with PsA were men compared with 64.3% of patients in the AS group. The Elixhauser Comorbidity Index (ECI) score was slightly higher in patients with AS compared to patients with PsA, and a greater number of patients with AS had an ECI score of 2 or higher. However, the distribution of comorbidities was similar between groups, with the most common comorbidity being hypertension.
At 12 months, patients with PsA had fewer hospitalizations compared to patients with AS (9.4% vs. 11.1%) and a lower proportion of emergency department visits (20.4% vs. 22%). Biologic medications were used by 52.5% of patients with AS and by 61.1% of patients with PsA, while 21.8% of patients with AS used a conventional disease-modifying anti-rheumatic drugs compared to 52.4% of patients with PsA.
Patients with PsA had an unadjusted mean medical cost of $5,108 compared to $6,514 for patients with AS. The unadjusted mean cost of prescription drugs was $11,214 for patients with AS compared to $14,174 for patients with PsA, of which biologics accounted for most of the costs.
Multivariate analysis showed adult patients with AS who were 64 years of age or younger had 18% to 30% higher direct costs than patients with the condition who were older than 65 years. Patients with PsA between the ages of 18 years to 34 years and 45 years to 64 years had 9% to 18% higher costs compared with patients aged 65 years or older, which had costs similar to patients aged 35 years to 44 years.
“In the multivariable analysis, use of biologics was the major driver for the high prescription drug cost,” the researchers wrote. “Higher all-cause direct costs were associated with younger age and higher number of comorbidities.” – by Shirley Pulawski
Disclosures: Greenberg reports consulting fees from Novartis. Please see the full study for a list of all other authors’ relevant financial disclosures.