Prescription Pattern Variability of Biologic Therapies in Treating Psoriasis

Background: Medical conditions with high variability in clinical costs and outcomes, such as psoriasis, represent a critical area for health-care value improvement. Thus, the prescription pattern variability of psoriasis biologics merits further study. Objective: The purpose of our study was to determine whether there is variation in psoriasis biologic prescribing patterns. Methods: This study analyzed data from the Truven MarketScan Commercial Claims and Encounters database. Patients with International Classification of Diseases, Ninth Revision psoriasis diagnoses from January 1, 2008, to December 31, 2013, and continuously enrolled for at least 12 months were included. Patient sex, geographic location by census region, and new pharmacy claims for etanercept, adalimumab, and ustekinumab were included. Descriptive and multivariable analyses using logistic regression were performed. Results: Twenty nine thousand seven hundred thirty patients with psoriasis had 36 366 new prescription claims. Statistically significant differences in biologic pharmacy claims existed across US census region and year of claim. The South census region had the most prescriptions (per million population) of each biologic and the greatest increase in new prescriptions for adalimumab and ustekinumab, while the Northeast had the fewest. Etanercept pharmacy claims steadily decreased across all regions over time, while ustekinumab experienced an 8-fold increase. Conclusion: Prescription pattern variability for psoriasis biologics is associated with US census region and year of pharmacy claim.