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Regional Difference...
Regional Differences in the Prescription of Biologics for Psoriasis in Sweden : a Register-Based Study of 4168 Patients
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- Calara, Paul S (author)
- IHE – The Swedish Institute for Health Economics
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- Althin, Rikard (author)
- IHE – The Swedish Institute for Health Economics
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- Carlsson, Katarina Steen (author)
- Lund University,Lunds universitet,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Hälsoekonomi,Forskargrupper vid Lunds universitet,Department of Clinical Sciences, Malmö,Faculty of Medicine,Health Economics,Lund University Research Groups,IHE – The Swedish Institute for Health Economics
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- Schmitt-Egenolf, Marcus, 1966- (author)
- Umeå University,Umeå universitet,Dermatologi och venereologi,Schmitt-Egenolf
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(creator_code:org_t)
- 2017-01-17
- 2017
- English.
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In: BioDrugs. - : Springer Science and Business Media LLC. - 1173-8804 .- 1179-190X. ; 31:1, s. 75-82
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Abstract
Subject headings
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Keyword
- Psoriasis
- Epidemiology
- discrimination
- postcode
- epidemiologi
- Epidemiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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