4CPS-080 Economic impact associated to biological therapy optimisation in patients with psoriasis

<h3>Background and Importance</h3> Optimisation of biological therapies is a frequent clinical practice to treat psoriasis in clinically controlled patients. The target is to guarantee effectiveness, improving adherence, reducing adverse effects (e.g. injection site reaction) and minimising associated costs. <h3>Aim and Objectives</h3> To estimate the economic impact of optimising the use of biological treatment in patients with psoriasis disease. <h3>Material and Methods</h3> A descriptive retrospective study was conducted between 1-july 2023 and 31-june 2024. Patients ≥18 years with plaque psoriasis treated with optimised biological therapies for at least 12 months uninterruptedly were analysed. Optimised therapies were defined as treatments with dose reduction or extended dosing regimens according to the summary of product characteristics (SPC). Patients with treatment discontinuations because of adequate disease control were excluded. These therapy optimisations were carried out according to a multidisciplinary protocol. Patients eligible for optimisation were those with an adequate response (Psoriasis Area Severity Index (PASI)≤3, Body Surface Area (BSA)&lt;3%, <i>Physician global assessment</i> (PGA)=0–1 and Dermatology Life Quality Index (DLQI)&lt;5) ≥6months. Variables were recorded from the hospital’s information systems: biological agent, dose regimens, treatment costs. Cost savings were calculated as the difference between total cost of real doses administered in optimised regimens in a year and the conventional treatment costs according to the SPC. <h3>Results</h3> We reviewed 482 patients with psoriasis, 13.3% (n=64) with optimised biological therapies. The treatment optimisation regimen used were: adalimumab (n=30, 48.4%): 40mg/21days (n=25); 40mg/4weeks (n=4); 40mg/6weeks (n=1); etanercept (n=4, 6.3%): 25mg/10days (n=1), 25mg/14days (n=1), 25mg/4weeks (n=1), 50mg/21days (n=1); ustekinumab (n=19, 29.7%): 45mg/14weeks (n=4), 45mg/15weeks (n=6), 45mg/16weeks (n=6), 45mg/18weeks (n=1), 90mg/16weeks (n=2); guselkumab (n=6, 9.4%): 100mg/10 weeks (n=1), 100mg/12weeks (n=5); risankizumab (n=1, 1.6%) 150mg/14weeks; tildrakizumab (n=1, 1.6%) 100mg/14weeks; brodalumab (n=1, 1.6%) 210mg/21days; secukinumab (n=2, 3.1%) 300mg/6weeks. During the study period, all optimised patients had disease remission. The total cost of optimised patients was €252657.40 against the use of conventional therapy (€350338.2), resulting in a reduction of −27.9% (cost saving: €97680.8/12 months). The number of drug administrations avoided was 580. <h3>Conclusion and Relevance</h3> In patients with plaque psoriasis, optimisation of biological therapies is a strategy to reduce costs and adverse effects by decreasing the number of drug administrations, maintaining the effectiveness. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest