Inequalities in access to biological treatments for psoriasis: results from the Italian Psocare registry

Br J Dermatol. 2017 May;176(5):1331-1338. doi: 10.1111/bjd.15234. Epub 2017 Apr 5.

Abstract

Background: Limited evidence is available on the impact of socioeconomic factors on drug prescriptions for psoriasis.

Objectives: To investigate factors influencing prescription of conventional vs. biological treatment for patients with psoriasis, based on the Italian Psocare registry, with a special focus on socioeconomic factors.

Methods: This was a cross-sectional study evaluating the baseline data of patients included in the Psocare registry. All of the consecutive adult patients with a diagnosis of chronic plaque psoriasis or psoriatic arthritis who were prescribed a systemic treatment for psoriasis at participating centres were included in this study. Univariate and multivariate analyses of the baseline factors associated with a biologics prescription were performed.

Results: From September 2005 to September 2009, 12 838 patients were identified. A multivariate analysis revealed that, among other factors, completing a level of education higher than lower secondary school and being employed as a manager or a professional were independent factors associated with a biologics prescription at entry in the registry. Additional analyses on the association between these two variables and a severe psoriasis condition [Psoriasis Area Severity Index (PASI) score > 20] revealed a significantly increasing trend of severe disease towards lower educational attainment, while unemployed patients were more likely to have a more severe condition compared with the other categories of workers.

Conclusions: We documented inequalities of drug prescriptions for psoriasis in Italy, with a trend towards a higher frequency of prescription for more expensive biologics in higher socioeconomic sectors of the population.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Biological Products / supply & distribution
  • Biological Products / therapeutic use*
  • Cross-Sectional Studies
  • Dermatologic Agents / supply & distribution
  • Dermatologic Agents / therapeutic use*
  • Drug Prescriptions / statistics & numerical data
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Prescription Drugs / supply & distribution
  • Prescription Drugs / therapeutic use
  • Psoriasis / drug therapy*
  • Registries
  • Socioeconomic Factors
  • Young Adult

Substances

  • Biological Products
  • Dermatologic Agents
  • Prescription Drugs