Objective: Psoriasis is a common chronic inflammatory immune-mediated skin disease which affects 3% of the US population and remains undertreated. This study examined utilization rates and time-to-treatment initiation of first-line therapy among newly diagnosed, commercially insured patients.

Methods: Adults under 65 years old with newly diagnosed psoriasis were identified in the IQVIA PharMetrics Plus® commercial claims database between January 1, 2016 and March 31, 2021. Patients had continuous enrollment for ≥1 year before and after the index diagnosis. The index diagnosis was determined by the first of two psoriasis diagnoses which occurred on separate visits that included the ICD-10-CM codes: L40.0 (Psoriasis vulgaris), L40.8 (Other psoriasis), and L40.9 (Psoriasis, unspecified). Outcomes examined were time-to-treatment initiation and utilization by treatment class.

Results: Among the 78,538 patients identified, mean age was 46 ± 12 years, and 54% were female. In the 12 months following diagnosis, 78.8% of patients initiated a treatment for psoriasis. The majority of patients initiated a topical treatment (90.7%). Other treatments received included traditional oral therapies (Methotrexate, Cyclosporine) (3.6%), targeted oral therapies (1.9%), biologics (3.2%), and phototherapy (1.4%). 91% of patients who initiated a topical started a topical steroid. Of the patients who received any psoriasis treatment in the 12 months following diagnosis, 68% started treatment within 7 days of the index diagnosis. Among the remaining patients who initiated treatment within 8-360 days post diagnosis, the median time to first treatment was 71 days for topicals, 51 days for traditional orals, 44 days for targeted orals, 53 days for biologics, and 44 days for phototherapy.

Conclusion: In the 12 months following the initial diagnosis of plaque psoriasis, the majority of patients initiated a topical treatment, with small percentages using first-line traditional orals, targeted orals, biologics, and phototherapy. However, a significant portion of patients remained untreated with any psoriasis-related therapy.