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. 2018 Jul 11;18(1):5.
doi: 10.1186/s12895-018-0074-0.

Persistence rates and medical costs of biological therapies for psoriasis treatment in Japan: a real-world data study using a claims database

Rosarin Sruamsiri  1   2 , Kosuke Iwasaki  3 , Wentao Tang  3 , Jörg Mahlich  4   5
Affiliations

Persistence rates and medical costs of biological therapies for psoriasis treatment in Japan: a real-world data study using a claims database

Rosarin Sruamsiri et al. BMC Dermatol. .

Abstract

Background: Biological therapies (BTs) including infliximab (IFX), adalimumab (ADL), secukinumab (SCK) and ustekinumab (UST) are approved in Japan for the treatment of psoriasis. Although the persistence rates and medical costs of BTs treatment have been investigated in multiple foreign studies in recent years, few such studies have been conducted in Japan and the differences between patients who adhered to treatment and those who did not have not been reported. This study is aimed at investigating the persistence rates and medical costs of BTs in the treatment of psoriasis in Japan, using the real-world data from a large-scale claims database.

Methods: Claims data from the JMDC database (August 2009 to December 2016) were used for this analysis. Patient data were extracted using the ICD10 code for psoriasis and claims records of BT injections. Twelve-month and 24-month persistence rates of BTs were estimated by Kaplan-Meier methodology, and 12-month-medical costs before and after BT initiation were compared between persistent and non-persistent patient groups at 12 months.

Results: A total of 205 psoriasis patients treated with BTs (BT-naïve patients: 177) were identified. The 12-month/24-month persistence rates for ADL, IFX, SCK, and UST in BT-naïve patients were 46.8% ± 16.6%/46.8 ± 16.6%, 53.0% ± 14.9%/41.0% ± 15.5%, 55.4%/55.4% (95% CI not available) and 79.4% ± 9.9%/71.9% ± 12.2%, respectively. Statistically significant differences in persistence were found among different BT treatments, and UST was found to have the highest persistence rate. The total medical costs during the 12 months after BT initiation in BT-naïve patients were (in 1000 Japanese Yen): 2218 for ADL, 3409 for IFX, 465 for SCK, 2824 for UST (average: 2828). Compared with the 12-month persistent patient group, the total medical costs in the persistent group was higher (Δ:+ 118), but for some medications such as IFX or UST cost increases were lower for persistent patients.

Conclusions: UST was found to have the highest persistence rate among all BTs for psoriasis treatment in Japan. The 12-month medical costs after BT initiation in the persistent patient group may not have increased as much as in the non-persistent patient group for some medications.

Keywords: Biological therapy; Claims database; Medical costs; Persistence; Psoriasis; Real-world data.

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Conflict of interest statement

Ethics approval and consent to participate

This was a retrospective study carried out using claims data from the commercial JMDC database; the authors were not involved in the collection of these data and data were anonymized before addition to the research database. Retrieval of the data from this database occurred in an unlinked fashion. As the data had been anonymized, the Ethical Guidelines for Epidemiological Research (Ministry of Education, Culture, Sports, Science and Technology, and Ministry of Health, Labor and Welfare of Japan), which require ethics approval and informed consent, are not applicable to this study. Based on the Ethical Guidelines on Biomedical Research Involving Human Subjects (Ministry of Education, Culture, Sports, Science and Technology, and Ministry of Health, Labor and Welfare of Japan), pharmacoepidemiological studies conducted on medical databases qualify as research carried out on pre-existing material and information that do not require any interventions or interactions with patients. For such studies, including this study, obtaining written informed consent from patients is not mandatory. The authors had permission from JMDC to access the database.

Consent for publication

Not applicable.

Competing interests

JM, and RS were affiliated with Janssen Pharmaceutical KK at the time the study was conducted, a company that develops and markets drugs for the treatment of psoriasis. KI and WT received honoraria from Janssen KK.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Measurement of non-BT refill period and medical costs. Legends: a Measurement of non-BT refill period. 1The treatment interval per individual prescription was defined as 30 days for ADL, IFX, SCK, and 90 days for UST. It was based on the approved dosage and treatment regimen for each BT, which is shown in Appendix A. 2Medication Gap: 60 days for ADL, IFX, SCK, and UST. b Measurement of medical costs
Fig. 2
Fig. 2
Cascade figure of patient flow. Legends: 1BT: biological therapies; 2for the purpose of analysis, multiple cycles of any BT treatment administered to one patient were counted as different patients. 3number of persistent patients during 12-month after BT initiation/number of total patients
Fig. 3
Fig. 3
Kaplan-Meier Curves of BT persistence in the BT-naïve and the total patient group Legends: a BT-naïve patient group (number: 177 patients). b Total patient group (number: 205 patients).
See this image and copyright information in PMC

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