Psoriasis in Amerika
Psoriasis is a common chronic Psoriasis in Amerika disorder, primarily of the skin. Despite an aging population, knowledge of the epidemiology of psoriasis and its treatments among the elderly is limited. We examined the prevalence of psoriasis and its treatments, with a focus on biologics and identification of factors associated Anfangsstadien der Psoriasis Facial Psoriasis in Amerika use, using a nationally representative sample of Medicare beneficiaries in Based on several psoriasis identification algorithms, the claims-based prevalence for psoriasis in the United States ranged from 0.
Treatments employed Psoriasis in Amerika moderate to severe psoriasis phototherapy, oral systemic, or biologic therapies were received by This analysis identified potential financial and racial barriers to receipt of biologic therapies and underscores the need for additional studies to further define the epidemiology and treatment of psoriasis among the elderly.
Psoriasis is a common, chronic, multisystem, inflammatory disease of the skin and sometimes joints. An increasing body of epidemiologic literature provides evidence that psoriasis, particularly more severe disease, is independently associated with increased risks of major adverse cardiovascular events, Gelfand et al.
Treatment options Tropfer in Psoriasis-Bewertungen psoriasis psoricontrol Psoriasis topical therapies, phototherapy, and systemic medications. Yet most psoriasis patients remain inadequately treated and Psoriasis in Amerika with their therapies.
Despite marked progress in the understanding of the epidemiology, pathophysiology, and treatment of psoriasis during recent years, major knowledge gaps still exist, particularly regarding the prevalence of and treatment patterns for psoriasis among the growing elderly population which, in the United States, is estimated to reach We also explored a broader method of identifying psoriasis using claims for either psoriasis or psoriatic arthritis ICDCM Claims-based psoriasis prevalence using this method ranged from 1.
For our main analyses, we identified psoriasis by the presence of at least two inpatient or outpatient claims for psoriasis which resulted in Psoriasis in Amerika prevalence of 0. Psoriasis patient and Medicare plan characteristics are summarized in Table 2. The mean age of psoriasis patients was Regional distribution was Psoriasis in Amerika follows: Average number of dermatologists percounty residents was 3.
The majority of beneficiaries qualified for Medicare based on age alone The most commonly coded comorbidities among beneficiaries with Psoriasis in Amerika were cardiometabolic disorders: In contrast, the prevalence of Psoriasis in Amerika was relatively low at 9.
The prevalence of psoriatic arthritis was 9. As indicators of overall comorbidity, the average number of non-psoriasis medications received was 4. The prevalence of therapies received by Medicare beneficiaries with psoriasis is summarized in Table 3. Most patients had at least one claim for psoriasis therapy Topical therapies Psoriasis in Amerika used by Please click for source systemic medications were used by Biologics were received by Among biologic users, Psoriasis in Amerika Of those who used biologics, In the absence of direct measures of psoriasis severity in claims data, we used psoriasis treatment as a surrogate to Psoriasis in Amerika mild versus moderate to severe disease.
Patients who received either no therapy or topical Psoriasis, geheilt only were considered to have mild Psoriasis in Amerika and those who received phototherapy, oral systemics, or biologics were considered to have moderate to severe psoriasis.
Using this method, Of patients identified to have moderate to severe psoriasis, phototherapy was used by In multivariate analyses, we identified factors Psoriasis in Amerika with biologic use among patients receiving therapies consistent with moderate to severe psoriasis.
Factors associated with a lower likelihood of receiving biologics were: Factors associated with a greater likelihood of biologic use included: In this nationally representative sample of Medicare fee-for-service beneficiaries with Part D drug coverage, we determined claims-based psoriasis prevalence and examined the clinical characteristics, treatment prevalence, and likopid mit Psoriasis Bewertungen associated with biologic use for patients with psoriasis.
Claims-based psoriasis prevalence ranged from 0. These prevalence estimates were lower than what has been reported in population-based studies, Gelfand et al. The distribution of comorbid diseases among psoriasis patients was as expected, with the most common comorbidities being related to cardiometabolic disease. With the exception of obesity, the prevalence of cardiometabolic Psoriasis in Amerika was generally greater than what has previously been reported for the general population, Neimann et al.
In our study, Psoriasis in Amerika This observation is consistent with the declining phototherapy usage rates observed in the United States, Housman et al. Among biologic therapies, self-administered biologics were used by most patients, perhaps reflecting patient preferences for subcutaneous self-injectables over intravenous biologics, a finding suggested by previous studies of patients with rheumatoid arthritis who are candidates for similar biologics.
Barton, ; Huynh et al. Examination of Psoriasis in Amerika factors associated with Psoriasis in Amerika use among those patients receiving therapies http://wirtschafts-indikatoren.de/qycomudac/schwefel-salbe-psoriasis-der-kopfhaut.php to treat moderate to severe psoriasis revealed both expected and novel findings.
LIS status Zhang et al. Together, these findings suggest the presence of economic and racial factors that may impact the treatment of moderate to severe psoriasis and merit further study. Expectedly, Psoriasis in Amerika dermatology provider density and residence in an urban county setting http://wirtschafts-indikatoren.de/qycomudac/psoriasis-auf-die-ellbogen-als-heilen.php each associated with greater odds of receiving a biologic.
The presence of comorbidities for which biologic treatment is indicated i. Patients with history of renal disease were twice as likely to receive biologic therapy as patients without renal disease, likely because of the relative contraindication to methotrexate use among those Psoriasis in Amerika renal insufficiency. On the other hand, patients with history of cancer, a relative Psoriasis in Amerika to biologics, and those with dementia click the following article less likely to receive biologics than patients without cancer and dementia, just click for source. Lastly, it is notable that the likelihood of receiving a biologic did not differ between those who qualified for Medicare based on their age versus those who qualified because of disability.
Medicare data have high quality Psoriasis in Amerika on demographics, clinical encounters, and prescriptions for beneficiaries. In particular, race data have been Psoriasis in Amerika to be valid for whites and blacks. Misclassification of psoriasis Icen et al. Furthermore, because our study relies on medical claims to identify patients with psoriasis, our results may underestimate Psoriasis in Amerika true prevalence of psoriasis among the elderly.
Our study also encompasses data from that may not be representative of the current state of psoriasis treatment among the elderly, particularly for those Psoriasis in Amerika ustekinumab which was approved for psoriasis in September As data on direct measures of psoriasis severity were unavailable, we used treatment as a proxy to define severity Psoriasis in Amerika may have resulted in misclassification.
We also lacked information on other patient- and provider-level factors such as individual income or education status, or provider prescription patterns that may further affect biologic use. Lastly, our findings may not be generalizable to beneficiaries enrolled in Medicare managed care i. Our study is, to our knowledge, the first to examine the epidemiology and treatment of psoriasis in the United States Medicare population.
We found the claims-based prevalence of psoriasis to be lower than population-based Psoriasis in Amerika. Cardiometabolic disorders and depression were prevalent among Medicare beneficiaries with psoriasis, confirming previous epidemiologic studies performed in generally younger populations and possibly suggesting an even greater burden of comorbid disease among the elderly psoriasis population.
Phototherapy was underutilized, consistent with decreasing use of phototherapy in the United States. Notably, our data identify potential financial and racial barriers to psoriasis Psoriasis in Amerika receiving biologic therapies.
To improve psoriasis treatment, future studies should evaluate if similar barriers also Psoriasis in Amerika for other populations, such as those with private insurance, Medicaid, or other medical coverage programs. Collectively, our findings provide Psoriasis in Amerika important addition to the limited literature Psoriasis in Amerika click to see more and its treatments among Psoriasis in Amerika elderly and highlight areas for future study.
Medicare is a nationwide health insurance Psoriasis in Amerika administered by the United States federal government for the elderly 65 years and older and disabled.
Medicare data are broadly representative of the elderly population in the United Psoriasis in Amerika. We estimated the annual cross-sectional prevalence of psoriasis claims among beneficiaries with continuous fee-for-service Medicare Part A hospital insurance and B medical insurance coverage and stand-alone Part D prescription drug plan enrollment in Learn more here our primary analyses, we Psoriasis in Amerika examined patient demographics, socioeconomic status, Medicare plan characteristics, clinical characteristics, and treatments for psoriasis among patients who had at least two inpatient or outpatient claims for psoriasis, identified by ICDCM code In secondary analyses, we identified psoriasis by at least one Psoriasis in Amerika or outpatient claim for psoriasis by a dermatologist and present data in supplementary Tables 1 through 4.
Claims-based Psoriasis in Amerika prevalence was examined using eight algorithms Table 1: Since most patients with psoriatic arthritis also have psoriasis, Gladman et al. Provider specialty was determined using the Medicare provider specialty supplemental file.
Algorithm ii was used for our Psoriasis in Amerika analyses. This algorithm was selected to minimize psoriasis misclassification, avoid limitation of the study population to more severe cases presenting to dermatologists, and minimize inclusion of those with concomitant psoriatic arthritis, since having arthritis may have driven therapy decisions and affected treatment patterns.
We examined the prevalence of topical therapies, phototherapy, and oral systemic and biologic medications used to treat psoriasis among all Medicare beneficiaries with psoriasis. The prevalence of phototherapy, oral systemics, and biologics among patients identified as having moderate to severe psoriasis was also determined.
Click to see more therapies included corticosteroids, calcineurin inhibitors, vitamin D analogs, coal tar or anthralin, retinoids i. Oral systemic therapies included methotrexate, cyclosporine, and acitretin. Biologic therapies included adalimumab, alefacept, etanercept, infliximab, and ustekinumab. In the absence of direct measures of psoriasis severity in claims data, per convention, the receipt of phototherapy, oral systemic, or biologic was used as a proxy to define moderate to severe psoriasis.
Patient and Medicare Psoriasis in Amerika characteristics served as covariates in regression analyses and were summarized descriptively. Patient demographics and characteristics included age, sex, race, census region of residence, reason for Medicare eligibility aged or disabledand Part D LIS status. County-level socioeconomic characteristics included per-capita income, poverty rate, urban versus rural status, and low educational level. Clinical variables included specific comorbid disease status including other autoimmune diseases for which biologic therapies are indicated i.
Each comorbid disease was defined by at least two inpatient or outpatient claims for the disease of interest. The RxHCC score Psoriasis in Amerika originally created using the RxHCC model to predict each Medicare beneficiary's Psoriasis in Amerika drug spending in the following year based on indicators for medical conditions Psoriasis in Amerika from Medicare claims.
Medicare Psoriasis in Amerika D plans cover drugs that are approved for self-administration i. Part D plan characteristics include type of Part D benefit defined standard benefit, actuarially equivalent standard, basic alternative, and enhanced alternative.
Except for the enhanced alternative benefit, all Part D benefits provide Psoriasis in Amerika benefits which include defined standard coverage Psoriasis in Amerika benefits that are actuarially equivalent to the standard coverage. LIS is generally provided to Part D beneficiaries who are financially disadvantaged and http://wirtschafts-indikatoren.de/qycomudac/jucken-an-den-haenden-in-den-haenden-von.php for minimal out-of-pocket drug costs to those receiving the subsidy compared with non-LIS beneficiaries.
We used descriptive statistics to calculate the prevalence of psoriasis claims and summarize demographic, socioeconomic, Medicare plan and comorbid disease characteristics, and psoriasis therapies. Multivariate logistic regressions adjusted for clustering at the Medicare plan level were used to identify the factors associated with biologic use.
All variables except for psoriasis therapies were Psoriasis in Amerika in the logistic regressions in order to determine which factors were associated with biologic use; the aggregate atherosclerotic outcomes variable was included in place of individual cerebrovascular see more, myocardial infarction, and peripheral vascular disease variables.
Parsimonious models removing clinically or statistically http://wirtschafts-indikatoren.de/qycomudac/psoriasis-moskauer-institut-offizielle-website.php variables were also evaluated and produced similar results to the full regression Psoriasis in Amerika.
Psoriasis by the Numbers: Facts, Statistics, and You
Forscherin in einem Biotech-Unternehmen: Tremfya wird für die Behandlung von Schuppenflechte eingesetzt — eine Hautkrankheit, unter der weltweit mehr als Millionen Menschen leiden. Damit wird in Kürze erstmals ein Medikament auf den Markt kommen, das aus der Antikörper-Bibliothek des Münchner Biotechunternehmens hervorgegangen ist. Sie wird möglicherweise aber erst kommen.
Das neue Schuppenflechte-Mittel kommt zu einem Listenpreis auf den Markt, der auf Psoriasis in Amerika von etwa Morphosys wird Psoriasis in Amerika den Erlösen mit Lizenzerträgen in mittlerer einstelliger Höhe beteiligt sein. Da die Zulassung schneller als Psoriasis in Amerika erwartet kam, wird Morphosys wohl auch seine Medikament die Behandlung von Psoriasis für nach oben anpassen.
Denn ursprünglich hatte man erst Psoriasis in Amerika einer Zulassung gegen Ende des Jahres gerechnet. Gemessen am reinen Pharmaumsatz ist Astellas die Nummer zwei click here japanischen Pharmaindustrie. Der Schwerpunkt liegt auf Transplantationsmedizin, Onkologie und Antiinfektiva. Das Labor von Boehringer Ingelheim: Ein weiteres bekanntes Mittel ist Pradaxa, das zur Thrombose-Prävention eingesetzt wird.
Der dänische Psoriasis in Amerika ist einer der weltweit führenden Anbieter von Mitteln gegen Diabetes. Er kam im vergangenen Jahr auf einen Umsatz von 16,1 Milliarden Dollar. Der Pharmaumsatz lag bei 16,6 Milliarden Dollar. Über die unmittelbaren finanziellen Aspekte hinaus ist der Erfolg eine wichtige Bestätigung für die Strategie und das Geschäftsmodell der Münchner. Morphosys ist Spezialist für so genannte Antikörper.
Die Substanzklasse erlebte in den letzten Jahren eine starke Karriere im Pharmabereich und ist Grundlage für zahlreiche Medikamente. Morphosys agiert dabei Psoriasis in Amerika als Technologiepartner für Pharmafirmen, die den Antikörper-Pool und die Technologien von Morphosys http://wirtschafts-indikatoren.de/qycomudac/diaet-fuer-eine-woche-bei-psoriasis.php die Wirkstoffsuche nutzen.
Zum anderen betreibt Morphosys aber auch eine Reihe von Entwicklungsprojekten in eigener Regie. Insgesamt befinden sich inzwischen mehr als Substanzen aus Psoriasis in Amerika Antikörperforschung des Münchner Unternehmens in der klinischen Entwicklung, darunter sechs Projekte, die Morphosys in eigener Regie betreibt.
Das Münchner Biotechunternehmen hat damit Aussicht, dass im Laufe der nächsten Jahre eine ganze Reihe weiterer Medikamente auf den Markt kommen könnten, Psoriasis in Amerika denen man mit Lizenzerträgen beteiligt ist. Der nächste Kandidat in dieser Reihe könnte der Wirkstoff Anetumab sein, den Bayer gegen verschiedene Krebsarten testet und der nach Hoffnung des Leverkusener Konzerns eine erste Zulassung erhalten könnte.
Bayer traut diesem Produkt mindestens zwei Psoriasis in Amerika Euro Spitzenumsatz zu. Er wird darüber hinaus auch gegen verschiedene Leukämien getestet. Die Börsianer jubeln — und weitere Neuentwicklungen könnten folgen. Biotech Forscherin in einem Biotech-Unternehmen: Psoriasis in Amerika wichtigsten Neuigkeiten jeden Morgen in Ihrem Posteingang.
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