The associations of depression and coping methods on health‐related quality of life for those with hidradenitis suppurativa

Abstract

generic versions (n 1⁄4 50,334 versus n 1⁄4 39,621, respectively). The mean annual costs of topical therapy per patient were $308.02 (standard deviation [SD], $314.71) and $160.37 (SD, $209.53) for branded and generic medications, respectively (P \\ .0001). The potential annual per-patient cost saving by switching from a branded medication to a generic was $147.65. Our study is limited by its retrospective nature, lack of Medicare and Medicaid claims, and dependency on International Classification of Diseases, Ninth Revision, code for rosacea that has not been validated. However, validity is supported by the high proportion of patients with dermatologist care. In summary, an important proportion of patients (24.2%) received combination topical therapy. These medications are thought to work by similar mechanisms (anti-inflammatory, antioxidant, and modulation of kallikrein related peptidase 5), and to our knowledge, they have not been studied together. Also, combination therapy is not discussed in most guidelines. We defined the cost of a topical medication as the sum of insurance payments, patient copay, and deductible per medication over the period of a year. We found that the mean annual cost of topical therapy for branded medications per person was nearly twice the cost of generics, despite the rise in generic drug costs. Thus, there is an opportunity to save health care costs, which amount to nearly $7.5 million annually for this cohort. Importantly, we analyzed the data from a health care system point of view, which provides more realistic overall cost analysis and is different from a patient point of view, in which, for example, coupons and other discounts reduce immediate out-of-pocket expense but increase societal cost. Our analysis suggests that there is an opportunity to increase utilization of generic medications and that combination topical therapy is commonly used. In addition, more research is needed to determine the most efficacious rosacea therapies. Topical therapy is common (used at a rate of 86% in this study) and may have lower adverse effects, yet topical agents can be more expensive than systemic medications. This is pertinent, given that about 24% of patients received combination topical therapy. More cost-effectiveness studies for rosacea therapy could inform providers, patients, and future guidelines.