Cost and access dynamics of JAK inhibitors utilized for dermatologic care

Janus Kinase (JAK) inhibitors may offer a more cost effective option for patients rather than biologics. This study sought to investigate if market competition has reduced the price and expanded access for those on JAK inhibitors. We utilized CMS Medicare spending data from 2018 to 2022 to investigate costs per dose, per beneficiary and change in total beneficiaries over time. Over this time frame baricitinib had a 26% cost per dose increase, 237% increase in total beneficiaries on the medication and 210% increase in cost per beneficiary. Upadacitinib had an 18% cost increase per dose, 1341% increase in beneficiaries on the medication and 289% increase in cost per beneficiary. Ruxolitinib had an 0.8% increase in cost per dose, 1534% increase in patients on the brand and 57% increase in cost per beneficiary. Tofacitinib had a 28% increase in cost per dose, 10% reduction in beneficiaries on the medication and 35% increase in cost per beneficiary. Tofacitinib XR had a 30% increase in cost per dose, 10% increase in patients on the medication and 60% increase in cost per beneficiary. Overall utilization and costs for each of the medications has increased over this time frame despite the increased utilization of biologics and the black box warning on these medications in this elderly population. This class of medications, despite its risks, may still not be the most cost-effective class for the individual and broader healthcare system.