Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population

In the Journal of the American Academy of Dermatology, Jalpa Doshi and colleagues, including Penxiang Li and Preethi Rao, investigate real-world utilization patterns of biologic therapy in Medicare beneficiaries with psoriasis. Studies indicate low adherence to biologics among patients with psoriasis, yet little is known about the adherence level in the Medicare population. Using data from the Medicare Chronic Condition Data Warehouse Part A, B, and D files with 12-month follow-up after index prescription, Doshi and colleagues conducted a retrospective claims analysis on 2707 patients initiating biologics. During the 12-month follow-up, 38% of participants were adherent, 46% discontinued treatment, 8% switched to another biologic and 9% later restarted biologic treatment. Being female and ineligible for low-income subsidies were associated with increased odds of decreased adherence. Medicare patients initiating biologics for psoriasis had low adherence and high discontinuation rates. Further investigation into reasons for inconsistent utilization, including exploration of patient and provider decision-making and barriers to more consistent treatment is needed.