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For Inflammatory Joint and Skin Disease, Switching More Common With Oral Than Injectable Immunotherapy

December 07, 2020

Patients who initiated oral immunotherapy to treat psoriasis, psoriatic arthritis, and rheumatoid arthritis were more likely to switch medications and had increased outpatient health care use compared with patients who initiated injectable immunotherapy, according to a study published in the Journal of Managed Care & Specialty Pharmacy

“Oral immunotherapy, however, was considerably less costly, which may be an essential consideration for treating patients who respond well to oral therapies,” researchers wrote. 

The retrospective observational study used claims data from a large US health plan to identify patients with initiated oral or injectable immunotherapy for chronic inflammatory joint and skin diseases. The study population included a total 6525 patients, of whom 4333 had a joint condition, 1216 a skin condition, and 976 a joint and skin condition. Some 894 patients initiated oral immunotherapy, and 5631 initiated injectable immunotherapy. Researchers followed patients for 12 months to investigate differences in treatment discontinuation, switching, health care resource utilization, and costs between the two routes of medication administration. 

Discontinuation rates did not differ between oral and injectable immunotherapy, but researchers found higher rates of switching to other immunotherapies in patients who initiated oral therapy. The finding, they observed, “may indicate lower effectiveness or tolerability of oral immunotherapies relative to injectables.” 

Meanwhile, users of oral therapy also had more outpatient and physician office visits during follow up compared with users of injectable immunotherapy, according to the study. 

“Health care resource utilization was higher in the oral group, but total costs were lower,” researchers reported, “which was likely driven by the lower costs of oral drugs.” 

Jolynn Tumolo 


Bhattacharya R, Herren K, Poonawalla I, Bunniran S, Bloomfield A, Schwab P. Comparing Medical Utilization and Cost Outcomes in Oral Versus Injectable Immunotherapy Users with Chronic Inflammatory Joint and Skin Diseases. J Manag Care Spec Pharm. 2020;26(10):1246-1256. doi:10.18553/jmcp.2020.26.10.1246

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