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This section of First Report Managed Care focuses on reporting the latest in health care economics and outcomes research for a variety of treatments and disease states.

After its initial approval for the treatment of psoriatic arthritis (PsA) in 2017, little data shows the economic impact of high affinity IL-17 inhibitor biologic ixekizumab for patients and payers alike.

According to science presented during AMCP’s eLearning Days, the majority of costs for ixekizumab treatment are associated with outpatient pharmacy costs and only 3.5% of costs were out-of-pocket expenses.

Bilal Atiya, PharmD, HEOR Therapeutic Consultant, Eli Lilly, and colleagues presented results from their retrospective cohort study in which adults, aged 18 years or older, initiating ixekizumab treatment were observed for a 12-month period of continuous enrollment with medical and pharmacy benefits between January 1, 2016 and July 31, 2019.

To be included in the cohort, patients had at least on PsA diagnosis (ICD-9 696.0x or ICD-10 L4050-L4059) in the 12 months prior to or on index.

Health care resource utilization and costs were reported per patient per month (PPPM) and adjusted for 2019 costs. Health care costs were also assessed after adjusting PsA treatment costs for discount rates reported by the Institute for Clinical and Economic Review (ICER), Dr Atiya and colleagues noted.

Of the included 496 patients (mean age 51.1 years; 50.4% female), 91.9% were treated with a different biologic prior to ixekizumab. The most common types were secukinumab [34.9%], adalimumab [28.8%] ustekinumab [21.4%]) and 93.4% had comorbid psoriasis.

At the end of the 12-month period, 6.9% of all patients had an inpatient admission and 24.8% reported an emergency room visit.

“The mean total all-cause and PsA related health care costs measured PPPM were $7,638 (SD=$5,370) and $6,113 (SD= $2,431), of which pharmacy costs for PsA treatment were the primary driver (97.5% of PsA-related costs),” explained Dr Atiya and colleagues. “While ixekizumab costs ($5,233 [SD= $2,497]) accounted for 85.6% of PsA-related health care costs, only 3.5% were patient out of pocket expenses (96.5% were health plan paid).”

The researchers adjusted for the ICER discount rate which lowered ixekizumab costs by 44% and other PsA treatment costs by 27.4%. This also decreased all-cause and PsA-related costs by $2,509 PPPM.

“Among PsA patients treated with ixekizumab, outpatient pharmacy costs for PsA treatment represent the majority of total and PsA-related health care costs,” concluded Dr Atiya and colleagues. “While ixekizumab was the primary driver of PsA-related health care costs only 3.5% of costs were patient out of pocket expenses.”

—Edan Stanley



Atiya B, Gellett A, Kern S, et al. Real World Healthcare Resource Utilization and Costs of Patients with Psoriatic Arthritis Treated with Ixekizumab. Poster presented at the AMCP eLearning Days, April 20–24, 2020.

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