Characteristics of Psoriasis Patients In Latin America

VA L U E I N H E A LT H 2 0 ( 2 0 1 7 ) A 8 5 3 – A 9 4 3

(535, 21.5), respectively.  Conclusions: Among the Latin American RA patients surveyed, many receiving a bDMARD or JAK inhibitor experience moderate-high levels of pain, have moderate-severe disease activity and remain clinically uncontrolled across a range of patient reported outcomes and clinical measures. PSY8 Characteristics of Psoriasis Patients In Latin America Burge R1, Galimberti R2, Goncalves L3, Lucas J4, Wang X5, Botello BS6, Brnabic A7 1Eli Lilly and Company, Indianapolis, USA; Division of Pharmaceutical Sciences, University of Cincinnati, Cincinnati, OH, USA, 2Universidad de Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina, 3Eli Lilly and Company, São Paulo, Brazil, 4Adelphi Real World, Bollington, UK, 5University of Toronto, Toronto, ON, Canada, 6Eli Lilly and Company, Mexico City, Mexico, 7Eli Lilly and Company, Sydney, Australia

Objectives: To present demographics and characteristics of Latin American psoriasis patients.  Methods: Data was obtained from the Adelphi Psoriasis Latin America Disease Specific Programme. Dermatologists completed patient record forms related to treatment practice, demographics and clinical characteristics for patients > 18 years old diagnosed with moderate-severe psoriasis for over 1 year who had received at least one systemic treatment. Patients provided consent prior to completing forms related to their symptoms.  Results: Dermatologists (n= 144) from Brazil (n= 40), Colombia (n= 30), Argentina (n= 35) and Mexico (n= 39) had a mean (SD) of 17.6 (9.6) practice years and on average saw 118.5 patients/5-day week. The analysis included 941 patients from Brazil (n= 320), Colombia (n= 179), Argentina (n= 209) and Mexico (n= 233); 56.4% were male, with mean (SD) age 49.5 (13.8) years, mean (SD) BMI 27.4 (4.9), and mean (SD) disease duration 12.2 (10.8) years. At the time of survey 44.1% of patients were classified as moderate-severe, 63.4% had PGA score 2-5, 31.9% had BSA > 10% and 31% were experiencing flare. Patients diagnosed as moderate-severe were undergoing treatment with biologic (32.7%), conventional systemic (53.4%) and combination therapy (12.6%); 48% moderate-severe patients were receiving a steroid and 13% phototherapy. Difficult to treat areas included scalp (40.0%), groin/genitals (11.5%) and palmar-plantar areas (20.8%). Most bothersome areas were scalp (29.2%), groin/genitals (9.9%), toes (8.1%) and soles of the feet (7.7%). Most common symptoms in patients regardless of severity were scaling (72.2%), inflamed skin (52.5%) and itching (44.5%). Comorbidities included hypertension (33.2%), hyperlipidemia (23.9%), anxiety (23.7%), depression (14.0%) and diabetes (18.1%). Approximately 60% were currently employed; of those unemployed or retired, 9% were unable to work due to psoriasis.  Conclusions: Psoriasis is a burdensome disease in Latin American patients due to its symptoms, impact on appearance, high incidence of comorbidities and presence of lesions in difficult to treat areas of the skin. PSY9 Burden of Disease for Psoriasis In Argentina, Brazil, Colombia and Mexico Papadimitropoulos M1, Romiti R2, Guerra MA3, Vorstenbosch E4, Brnabic A5, Haynes G6, Goncalves L7, Leonardi Reyes F8, Garcia EG9, Burge R10 1Eli Lilly and Company, Canada; University of Toronto, Toronto, ON, Canada, 2Hospital das Clínicas University of São Paulo (USP), São Paulo, Brazil, 3Monterrey, Nuevo Leon, Mexico, 4Parc Sanitari Sant Joan de Deu, Barcelona, Spain, 5Eli Lilly and Company, Sydney, Australia, 6Eli Lilly and Company, Indianapolis, IN, USA, 7Eli Lilly and Company, São Paulo, Brazil, 8Eli Lilly, Bogota, Colombia, 9Elil Lilly and Co, Mexico City, Mexico, 10Eli Lilly and Company, Indianapolis, USA; Division of Pharmaceutical Sciences, University of Cincinnati, Cincinnati, OH, USA

Objectives: Psoriasis is a common, chronic skin disease, affecting approximately 2% of the population. There is much variability in prevalence and impact studies across the world, and few numbers are known from Latin-America. The objective of this study is to conduct a systematic review on disease burden for psoriasis (PS) and psoriatic arthritis (PsA) in the four most populated Latin-American countries, namely Argentina, Brazil, Colombia and Mexico.  Methods: PubMed/ Medline, Web of Science and grey literature databases (BASE, MediGraphic and PDF Search Engine) were searched for publications in English, Spanish or Portuguese at January 21st 2016. Additionally, regional journals and professional and patient association web pages were consulted. The AMSTAR quality criteria were taken into account.  Results: Out of 565 records, 317 unique records met the predetermined inclusion criteria. The estimated age-standardized prevalence of psoriasis for these countries ranged from 1.27% to 1.56%. Concerning the prevalence of moderate/ severe psoriasis, no epidemiology studies were identified. Prevalence estimations came from single-centre studies with heterogeneity in study samples and severity classifications, data varied between 19% (Mexico) and 90% (Argentina). Treatment forms varied per country and institution being most prevalent topical therapy (22%100%) and conventional systemic therapy (32%-62%) whereas few used biological therapy (2%-12%). The most frequent co-morbid disorders were obesity, metabolic and cardiovascular problems, and anxiety and depression. Impact in terms of health related quality of life was higher than in other dermatological diseases. Most cost analyses focused on the cost-effectiveness of treatment interventions. A cost-ofillness study from Colombia found that total annual cost per patient was $12,595 for private practice and $10,895 for the public sector.  Conclusions: The burden of psoriasis in Latin America is large. However, evidence is still scarce and more studies are needed to evaluate the full cost and impact of the disorder in Latin American countries. PSY10 Treatment Patterns and Satisfaction For Rheumatoid Arthritis Patients In Latin America Undergoing Advanced Therapy Papadimitropoulos M1, Mysler E2, Garcia EG3, Lobosco S4, Botello BS5, Leonardi Reyes F6, Haynes G7 Lilly and Company, Canada; University of Toronto, Toronto, ON, Canada, 2Reumatología, Organización Médica de Investigación, Buenos Aires, Argentina, 3Elil Lilly and Co, Mexico City, Mexico, 4Adelphi Real World, Macclesfield, UK, 5Eli Lilly and Company, Mexico City, Mexico, 6Eli Lilly, Bogota, Colombia, 7Eli Lilly and Company, Indianapolis, IN, USA 1Eli

A891

Objectives: To describe treatment use, switching and satisfaction in Latin American rheumatoid arthritis (RA) patients currently prescribed advanced therapy.  Methods: Data was obtained from the Adelphi Rheumatoid Arthritis Latin America Disease Specific Programme, a cross-sectional survey of rheumatologists and their RA patients. Rheumatologists (n= 188) from Brazil, Argentina, Colombia, Mexico and Venezuela completed patient record forms related to treatment for 801 patients currently receiving a biologic disease modifying antirheumatic drug (bDMARD) or JAK inhibitor. Self-reported data was collected from patients.  Results: Of the 789 patients currently receiving advanced therapy; 97.0% were receiving bDMARDs and 3.0% JAK inhibitors. Their physicians planned to continue the current treatment for nearly all (94.4%) patients. Of the patients on bDMARDs, 72.7 % were currently treated with an anti-TNF biologic compared to 27.3% with a non-TNF biologic. On average, patients had been treated with their current therapy for mean (SD) of 20.6 (20.4) months; patients were treated longer with anti-TNFs than non-anti-TNFs (mean [SD] months of 21.5 (21.5) and 18.4 (17.2), respectively). Most patients (87.6%) were being treated with a conventional disease modifying antirheumatic drug (cDMARD) in combination with the bDMARD or JAK inhibitor. Approximately 73.2% of patients had been treated with two or more cDMARDs prior to initiation of biologic treatment. Most patients (79.2%) were currently receiving a first-line biologic, 18.1% were receiving a secondline and 2.7% receiving their third or more biologic. Most (77.4%) rheumatologists and patients (77.1%) were satisfied with the control achieved for the current treatment. The main reason rheumatologists switched treatment was a loss of response (51.9%).  Conclusions: This data suggests that most of the bDMARD or JAK inhibitor RA patients surveyed from Latin America also received a cDMARD and were satisfied with treatment. The majority of patients received multiple cDMARDs prior to current treatment.

SYSTEMIC DISORDERS/CONDITIONS – Cost Studies PSY11 Budget Impact of Introducing Secukinumab In The Treatment of Moderate-To-Severe Plaque Psoriasis From The Private Payer Perspective In Brazil Suzuki C, Lopes N Novartis Biociências SA, Sao Paulo, Brazil

Objectives: To evaluate the budget impact of including secukinumab for the treatment of moderate-to-severe plaque psoriasis patients from the perspective of the Brazilian private healthcare system over five years. Methods: Excelbased model was developed to estimate investment required for inclusion of secukinumab, as an additional biologic alternative by comparing two scenarios: “without-secukinumab” versus “with-secukinumab”. Number of patients eligible for biologic therapy was calculated considering: (1)hypothetical population of 1,000,000; (2)prevalence of psoriasis patients about 1%; (3)85% of these are plaque psoriasis patients; (4)20% presenting moderate-to-severe disease; (5)50% are eligible for systemic therapy; (6)40% of these are eligible for biologic therapy; (7)annual discontinuation rate of biologic therapy: around 10%; and (8)from the second year on, an annual incidence of 59.9/100,000 was considered to calculate new psoriasis patients entrance. 25% and 20% of market share for each biologic was considered in the “without-secukinumab” and “with-secukinumab” scenarios, respectively. Drug annual costs were based on the respective ex-factory prices and the recommended dosages. Infliximab cost was based on an average body weight of 70kg.  Results: The number of patients eligible for treatment with biologic agents was estimated to be around 340 in the first year with an incidence of 20. The annual costs of maintenance therapy with biologic agents were estimated to be: BRL46,614 (ustekinumab 45mg); BRL74,778 (secukinumab); BRL87,748 (etanercept); BRL93,227 (ustekinumab 90mg); BRL96,533 (adalimumab); BRL96,607 (infliximab 100mg). The total budget impact was negative around: -BRL4 million in 5 years (average: -BRL838K per year) [1BRL= 0,32USD; 30/Jan/2017].  Conclusions: The annual maintenance therapy cost with secukinumab is the second lowest cost among all biologic agents. The introduction of secukinumab could generate savings from the perspective of private healthcare system according to this model. To evaluate the budget impact of including secukinumab for the treatment of moderate-to-severe plaque psoriasis patients from the perspective of the Brazilian private healthcare system over five years. PSY12 Budget Impact of The Inclusion of Oxycodone In The Brazilian Public Healthcare Setting For The Treatment of Cancer Pain Souza DA1, Aguiar EC1, Miguel AK2, Rosim RP2, Ballalai Ferraz AF2 Paulo, Brazil, 2QuintilesIMS, São Paulo, Brazil

1Mundipharma, São

Objectives: Oxycodone is a strong opioid absent from Brazilian federal guidelines (PCDT) for cancer pain treatment. According to literature, it is an effective option for opioid rotation for the control of pain in oncologic patients. The goal of this study is to calculate the budget-impact of the inclusion of oxycodone for cancer pain to the PCDT.  Methods: SUS claim databases (DataSUS) reports the number of patients using each of the opioids available in Brazil, however it does not report dispensed opioids for all Brazilian states. To estimate the total number of patients with cancer pain using strong opioids, we selected patients using opioids during cancer treatment and extrapolated the number of patients based on the proportion of the population present in the states that report opioid consumption. Also based on DataSUS databases, mean treatment period was assumed to be 4.5 months. We assumed that the population growth would be the same as that of cancer incidence and that oxycodone’s market share at peak would be 25%, since in the literature 1/4 of the patients may not respond to morphine, reached within four years after protocol inclusion. Only drug costs were considered and time horizon is five years. One-way sensitivity analysis was performed in order to test which parameters most affect the result of the analysis.  Results: The estimated number of patients using