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The influence of socioeconomic factors on access to biologics in psoriasis
The Swedish Institute for Health Economics (IHE), Lund, Sweden.
The Swedish Institute for Health Economics (IHE), Lund, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-3858-8474
2023 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, no 23, article id 7234Article in journal (Refereed) Published
Abstract [en]

Background: Since the introduction of biologics for psoriasis, uptake has been uneven and limited. Few studies have investigated the influence of socioeconomic factors on access to biologics.

Objective: To investigate how socioeconomic factors influenced access to biologics.

Methods: Biologic-naïve patients in the Swedish National Register for Systemic Treatment of Psoriasis (PsoReg) for the years 2006–2014 were included. For patients who remained on nonbiologic treatments during their entire registration (n = 1851), the most recent registration was analyzed. For patients who began treatment with biologics during registration in PsoReg (n = 665), the last observation before initiation of biologics was analyzed. A logistic regression model was used to investigate whether education and income influenced the probability of a switch to biologics, whilst adjusting for demographic and individual factors such as age, sex, disease severity, and clinical characteristics.

Results: The odds ratio of access to biologics was 1.8 (CI = 1.3–2.6) in the group with a high level of disposable income, compared with the middle-income group. No differences were found concerning educational levels. The odds ratios of access to biologics decreased with age. Patients with psoriatic arthritis had odds ratios of access to biologics which were more than 50 percent higher, controlling for other variables. High disease severity, in terms of physician- and patient-reported severity, increased the odds ratios of access to biologics.

Conclusions: The higher-income group had better access to biologics than the middle-income group when adjusting for disease severity and lifestyle factors. This may not only be an equity problem, as a better allocation of society’s resources might have resulted in a higher overall effectiveness of biologics.

Place, publisher, year, edition, pages
MDPI, 2023. Vol. 12, no 23, article id 7234
Keywords [en]
access, biologics, DLQI, PASI, psoriasis, socioeconomic
National Category
Dermatology and Venereal Diseases
Identifiers
URN: urn:nbn:se:umu:diva-218294DOI: 10.3390/jcm12237234ISI: 001116953900001PubMedID: 38068286Scopus ID: 2-s2.0-85179372437OAI: oai:DiVA.org:umu-218294DiVA, id: diva2:1822240
Funder
Swedish National Board of Health and WelfareSwedish Association of Local Authorities and RegionsStiftelsen PsoriasisfondenAvailable from: 2023-12-22 Created: 2023-12-22 Last updated: 2023-12-22Bibliographically approved

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Schmitt-Egenolf, Marcus

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CiteExportLink to record
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