4CPS-134 Evolution and analysis of spending on biological medication in psorasis

Background Biological drugs represent a great economic impact for the pharmacy service, where dermatology is one of the services with greatest use of this type of drugs. Purpose To describe and analyse the evolution of expenditure on biological drugs of subcutaneous administration for the treatment of psoriasis in the dermatology service. Material and methods Retrospective study which includes all patients who have been given biological drugs with subcutaneous administration for the treatment of psoriasis from January 2011 to December 2016. Parameters collected were: number of patients per drug, economic expenditure (€) and percentage of total expenditure. Data were obtained through the Prisma ® prescription and validation program, and collected in an Excel ® database designed for this purpose. Results Four drugs were identified: adalimumab, etanercept, ustekinumab and secukinumab. The total number of patients was 114 in 2012 (29 adalimumab, 51 etanercept, 34 ustekinumab), 126 in 2013 (35 adalimumab, 50 etanercept, 41 ustekinumab), 128 in 2014 (35 adalimumab, 46 etanercept, 47 ustekinumab), 136 in 2015 (36 adalimumab, 48 etanercept, 52 ustekinumab) and 149 in 2016 (49 adalimumab, 41 etanercept, 58 ustekinumab, 1 secukinumab). The cost progression was €8 50 236 in 2012, €1,245,813 in 2013, €1,228,421 in 2014, €1,205,766 in 2015 and €1,211,130 in 2016. Regarding the average cost per patient, it is €8858 for adlimumab, €7509 for etanercept, €9967 for ustekinumab and €24 056 for secukinumab. Spending on biological medication for psoriasis equals approximately 4% of the total hospital pharmacy budget. Conclusion During the past 5 years there has been an increase of 30.7% of patients undergoing biological treatment. The greatest increase in the number of patients is observed in treatment with adalimumab and ustekinumab. The cost has been increased to €360,894, which represents an increase of 42% from 2012 to 2016. The drug with a lower cost per patient year is etanercept, followed by adalimumab, while secukinumab is the most costly. With only four drugs, psoriasis represents an important part of the total pharmacy budget. No conflict of interest