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Regional Differences in the Prescription of Biologics for Psoriasis in Sweden: a Register-Based Study of 4168 Patients
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. (Schmitt-Egenolf)ORCID iD: 0000-0002-3858-8474
2017 (English)In: BioDrugs, ISSN 1173-8804, E-ISSN 1179-190X, Vol. 31, no 1, 75-82 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Observational studies suggest an inequitable prescription of biologics in psoriasis care, which may be attributed to geographical differences in treatment access. Sweden regularly ranks high in international comparisons of equitable healthcare, and is, in connection with established national registries, an ideal country to investigate potential inequitable access.

OBJECTIVE: The aim was to determine whether the opportunity for patients to receive biologics depends on where they receive care.

METHODS: Biologic-naïve patients enrolled in the Swedish National Register for Systemic Treatment of Psoriasis (PsoReg) from 2008 to 2015 (n = 4168) were included. The association between the likelihood of initiating a biologic and the region where patients received care was analyzed. The strength of the association was adjusted for patient and clinical characteristics, as well as disease severity using logistic regression analysis. The proportion of patients that switched to a biologic (switch rate) and the probability of switch to a biologic was calculated in 2-year periods.

RESULTS: The national switch rate increased marginally over time from 9.7 to 11.0%, though the uptake varied across regions. Adjusted odds ratios for at least one region were significantly different from the reference region in every 2-year period. During the latest period (2014-2015), the average patient in the lowest prescribing region was nearly 2.5 times less likely to switch as a similar patient in the highest prescribing region.

CONCLUSIONS: Geographical differences in biologics prescription persist after adjusting for patient characteristics and disease severity. The Swedish example calls for further improvements in delivering equitable psoriasis care.

Place, publisher, year, edition, pages
2017. Vol. 31, no 1, 75-82 p.
Keyword [en]
Psoriasis, Epidemiology, discrimination, postcode
National Category
Dermatology and Venereal Diseases
Research subject
Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-130437DOI: 10.1007/s40259-016-0209-yISI: 000393693000005PubMedID: 28097638OAI: oai:DiVA.org:umu-130437DiVA: diva2:1067093
Available from: 2017-01-20 Created: 2017-01-20 Last updated: 2017-08-14Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
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  • Other locale
More languages
Output format
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  • asciidoc
  • rtf