TOPLINE:

Out-of-pocket medication costs for psoriasis or psoriatic arthritis (PsA) were linked to poor treatment adherence and discontinuation in a claims analysis.

METHODOLOGY:

• Researchers analyzed claims from two different databases from 2018 to 2022 for 19,284 patients (mean age, 50.8 years; 52.3% women) with psoriasis and/or PsA.
• Out-of-pocket costs included total deductible, copay, and coinsurance payments over 12 months and were categorized by 30-day medication supply cost.
• Adherence was based on proportion of days covered, with values of 0.80 or higher classified as adherent. Medication switches or treatment gaps of 90 days or longer were counted as discontinuation.

TAKEAWAY:

• Overall, only 38.6% of patients adhered to therapy, and 54.4% discontinued treatment within 1 year.
• Patients paying $15-$999 for a 30-day supply showed higher adherence (adjusted relative risk [aRR], 1.23, 1.32, 1.77, and 1.55 for those paying $15-$99, $100-$249, $250-$499, and $500-$999, respectively) and lower discontinuation rates (aRR, 0.87; 95% CI, 0.84-0.90) than those paying less than $15.
• Patients with out-of-pocket costs of $1000 or more were significantly less likely to adhere to therapy than those in the lowest cost group (aRR, 0.80; 95% CI, 0.74-0.86).
• The authors noted that the adherence results may be related to patients paying $15-$999 using medications “positioned more favorably on formularies due to PBM [Pharmacy Benefit Manager] rebate incentives, enabling greater treatment continuity.”

IN PRACTICE:

“In this study, rates of treatment adherence and discontinuation varied significantly by out-of-pocket costs,” the authors wrote. This research, they added, “provides valuable insights to guide advocacy efforts aimed at reducing treatment costs and increasing access to care for patients with psoriatic disease.”

SOURCE:

This study was led by Alyssa M. Roberts, University of Hawaii at Manoa John A. Burns School of Medicine, Honolulu, and was published online on December 4 in JAAD International.

LIMITATIONS: 

The authors did not list any study limitations.

DISCLOSURES:

This study was funded by the National Psoriasis Foundation/US. One author disclosed serving as a research investigator, scientific advisor, or speaker to AbbVie, Alumis, BMS, Galderma, J&J, Leo, Lilly, Novartis, Pfizer, Regeneron, Sanofi, Sun, Takeda, and UCB. The remaining authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.