Ann Dermatol.  2018 Dec;30(6):668-675. 10.5021/ad.2018.30.6.668.

Economic Factors as Major Determinants of Ustekinumab Drug Survival of Patients with Chronic Plaque Psoriasis in Korea

• Choi CW
• Yang S
• Jo G
• Kim BR
• Youn SW

• KMID: 2428922
• DOI: http://doi.org/10.5021/ad.2018.30.6.668

Abstract

BACKGROUND
Drug survival, defined as the time until discontinuation, is a parameter reflecting real-world therapeutic effectiveness. Few studies have examined the influence of economic factors on the drug survival of biologic agents for psoriasis, particularly in Asian countries.
OBJECTIVE
To determine the drug survival for ustekinumab in real-life settings and investigate the factors affecting drug survival for psoriasis patients in Korea.
METHODS
We evaluated 98 psoriasis patients who were treated with ustekinumab at a single center. We analyzed the efficacy and drug survival of ustekinumab. Cox proportional hazard analysis and competing risk regression analysis were performed to reveal the factors affecting the drug survival of ustekinumab.
RESULTS
The overall mean drug survival was 1,596 days (95% confidence interval [CI], 904~2,288). Among the 39 cessations of ustekinumab treatment, 9 (23.1%) patients discontinued treatment after experiencing satisfactory results. Multivariate Cox proportional hazard analysis revealed that paying on patients' own expense was the major predictor for the discontinuation of ustekinumab (hazard ratio [HR], 9.696; 95% CI, 4.088~22.998). Competing risk regression analysis modeling of discontinuation because of factors other than satisfaction of an event also revealed that ustekinumab treatment at the patient's expense (HR, 4.138; 95% CI, 1.684~10.168) was a predictor of discontinuation rather than satisfaction.
CONCLUSION
The results of our study revealed that the cost of biologics treatment affects the drug survival of ustekinumab and suggested that economic factors affect the drug survival of ustekinumab treatment in Korea.

Keyword

Costs and cost analysis; Drug survival; Economic factors; Psoriasis; Ustekinumab

MeSH Terms

Asian Continental Ancestry Group
Biological Factors
Biological Products
Costs and Cost Analysis
Humans
Korea*
Psoriasis*
Ustekinumab*
Biological Factors
Biological Products
Ustekinumab

Figure

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  Fig. 1 Overall ustekinumab drug survival and comparison of drug survival between treatment covered by insurance and treatment paid at their own expense. Log-rank test revealed significant differences in drug survival between ustekinumab treatment covered by insurance and on their own expenses (p<0.001).

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