Dataset Information

Prescription Market Share and Treatment Patterns in Atopic Dermatitis: A Retrospective Observational Study Using US Insurance Claims.

ABSTRACT:

Introduction

There is limited real-world evidence on the treatments for atopic dermatitis (AD) since dupilumab was approved in 2017. The objective of this study was to assess market share of drugs commonly prescribed for the treatment of AD and describe treatment patterns in patients diagnosed with AD.

Methods

This was a retrospective, observational study in adult patients with an ICD-10 diagnosis of AD between 2017 and 2019 using insurance claims data in the US population.

Results

Market share cohorts consisted of 75,794 (2017) and 89,618 (2018) patients. Treatment patterns cohort had 68,588 patients with 63.56% female, mean (SD) age 43.54 (15.96) years, and mean (SD) Quan CCI 0.31 (0.85). Topicals had two-thirds market share by prescription volume (2017 = 65.56%; 2018 = 63.63%). Corticosteroids were the most prescribed topical (2017 = 71.94%; 2018 = 72.04%) and systemic (2017 = 30.59%; 2018 = 30.23%) drug class. Dupilumab had the highest medication adherence (proportion of days covered [PDC] ≥ 80%; 60.74%) and persistence (17.39%), lowest discontinuation rate (23.32%), and longest mean (SD) days on therapy 148.20 (101.77).

Conclusion

Topicals are the primary treatment for patients with AD, even though systemic users have higher medication adherence (PDC). Systemics provide a treatment alternative to topicals.

SUBMITTER: Fenske C

PROVIDER: S-EPMC9056466 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Prescription Market Share and Treatment Patterns in Atopic Dermatitis: A Retrospective Observational Study Using US Insurance Claims.

Fenske Christian C Boytsov Natalie N Guo Jiaying J Dawson Zach Z

Advances in therapy 20220314 5

<h4>Introduction</h4>There is limited real-world evidence on the treatments for atopic dermatitis (AD) since dupilumab was approved in 2017. The objective of this study was to assess market share of drugs commonly prescribed for the treatment of AD and describe treatment patterns in patients diagnosed with AD.<h4>Methods</h4>This was a retrospective, observational study in adult patients with an ICD-10 diagnosis of AD between 2017 and 2019 using insurance claims data in the US population.<h4>Res ...[more]

PMID: 35287230

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Project description:IntroductionThe literature on treatment patterns for paediatric atopic dermatitis (AD) is scarce and is rarely based on real-world data. Using national registers, we sought to establish up-to-date, population-based prevalence estimates, predictors of risk and disease burden and a comprehensive overview of treatment patterns and course for paediatric patients with AD.MethodsDispensed prescriptions for the entire Norwegian child population aged 0-10 years from 2014 to 2020 were analysed.ResultsThere were 176,458 paediatric patients with AD. Of these, 99.2% received topical corticosteroids, 5.1% received topical calcineurin inhibitors, 37.1% received potent topical corticosteroids and 2.1% received systemic corticosteroids. Of the 59,335 live births in Norway (2014), 14,385 [24.8%; 95% confidence interval (CI) 24.5-25.1] paediatric patients were treated for AD before the age of 6 years, and of these, only 934 (6.5%; 95% CI 6.1-6.9) received medication annually for 5 years or more. Compared with girls, 17.9% (95% CI 6.5-27.9) more boys were treated for at least 5 years, receiving 6.4% (95% CI 1.2-11.3) more potent topical corticosteroids and 12.4% (95% CI 6.5-18.0) more were treated for skin infections. Compared with patients with late-onset treatment, 18.9% (95% CI 7.5-29.0) more paediatric patients with early-onset treatment were still receiving treatment at 5 years of age, 15.7% (95% CI 7.1-23.4) more paediatric patients received potent topical corticosteroids and 44.4% (95% CI 36.5-51.2) more paediatric patients were treated for skin infections.ConclusionMost paediatric patients were treated for a mild disease for a limited period. Although the prevalence of AD is higher at a younger age, these paediatric patients were the least likely to receive potent topical corticosteroids. Male sex and early-onset AD are associated with and are potential predictors of long-term treatment and treatment of potent topical corticosteroids, antihistamines and skin infections, which may have clinical utility for personalised prognosis, healthcare planning and future AD prevention trials.

Project description:ObjectivesAdministrative database research is pivotal for developing guidelines in cardiovascular surgery and valvular heart disease. However, validation studies specific to Asia are lacking. This study validated the coding of valvular heart repair and replacement surgeries in Taiwan's National Health Insurance (NHI) Research Database using International Classification of Diseases, Clinical Modification (ICD-CM) codes.MethodsThis retrospective observational study used data from the Chang Gung Research Database between 2015 and 2018, identifying 1171 patients using Taiwanese NHI reimbursement codes. The gold standard was defined as a blinded retrospective review of operation notes. Claims data, including ICD diagnostic codes, ICD procedural codes and NHI supply codes for surgical materials, were validated. Positive predictive values (PPVs) were calculated as the number of true positives divided by the total claims data.ResultsThe PPVs (95% CI) for aortic valve (AV) surgery aetiologies were as follows: infectious endocarditis (IE), 94.1% (87.6%-97.7%); rheumatic heart disease (RHD), 88.2% (67.3%-97.5%); bicuspid AV, 93.3% (83.3%-98.1%); and degeneration, 91.7% (85.3%-95.8%). For mitral valve surgery, the surgery aetiologies and PPVs were IE, 93.2% (87.9%-96.6%); RHD, 94.9% (88.3%-98.2%); ischaemic mitral regurgitation, 87.5% (73.0%-95.6%); and degeneration, 88.4% (83.9%-92.0%). Surgical types generally exhibited higher PPVs, except for mechanical prostheses (<90%). The accuracy of mechanical prosthesis identification improved with the inclusion of supply codes along with ICD procedural codes.ConclusionsThe PPVs for both aetiologies and surgical types of valvular heart disease were generally satisfactory. The inclusion of supply codes for mechanical valve replacements enhanced accuracy but led to fewer eligible patients being included in the sample. This study provides a potentially optimal framework for future research on valve diseases and surgeries using claims databases.

Dataset Information

Prescription Market Share and Treatment Patterns in Atopic Dermatitis: A Retrospective Observational Study Using US Insurance Claims.

Introduction

Methods

Results

Conclusion

Publications

Prescription Market Share and Treatment Patterns in Atopic Dermatitis: A Retrospective Observational Study Using US Insurance Claims.

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