OBJECTIVES: Biologics and tsDMARDs are effective treatment options in the management of PsA leading to approval of many new agents in recent years. This study used administrative claims data to assess healthcare costs of patients with PsA treated with biologics and tsDMARDs.

METHODS: Adults (age ≥18 years) on any approved PsA biologic (except ixekizumab) or tsDMARD between 1/1/2016-7/31/2019 were selected from the IBM MarketScan Commercial and Medicare Supplemental administrative claims databases. The first claim for treatment was set as the study index date. Patients were required to have continuous enrollment in their health plans for 12 months +/- index (pre-index and post-index) and have at least one diagnosis of PsA (ICD-9 696.0x or ICD-10 L4050-L4059) in the pre-index period. PsA-related healthcare costs (adjusted to 2019 dollars) were reported per patient per month (PPPM) for 12 months post-index.

RESULTS: There were 6,674 patients eligible for analysis (mean age 48-59 across cohorts). Most patients indexed on adalimumab (37.2%) followed by apremilast (25.5%), etanercept (18.0%), secukinumab (5.5%), and ustekinumab (5.4%). The remaining 8.4% included abatacept, golimumab, certolizumab, infliximab, and tofacitinib. The mean total PsA-related healthcare costs PPPM ranged from $2,647 (SD $1,583) for apremilast to $5,159 (SD $3,155) for ustekinumab. Across all cohorts, PsA index drug costs comprised the majority (69%-88%) of total PsA-related healthcare costs, but only 2%-5% were patient out of pocket expenses. Average index drug costs PPPM ranged from $1,874 (SD $1,126) in the apremilast cohort to $4,514 (SD $3,163) in the ustekinumab cohort. The secukinumab cohort was the only other with index drug costs over $4,000.

CONCLUSIONS: This study provides real world data on the costs of biologics and tsDMARDs among patients with PsA. Drug costs comprise the largest share of healthcare costs in patients with PsA and most of these costs are covered by health plans.