INTRODUCTION
Disease control for moderate to severe atopic dermatitis (AD) has been primarily achieved with phototherapy and non-specific immunomodulators, cyclosporine, and methotrexate. These treatments have, however, been associated with many unfavorable side effects.
In 2017, dupilumab was Food and Drug Administration (FDA)- approved as a first-line treatment for moderate-to-severe AD, and it has demonstrated a favorable safety profile. However, it is currently the most expensive treatment for AD, averaging $30,000 per course for one year.1 A significant economic burden of AD exists, and it is important for healthcare providers, both dermatologists and non-dermatologists alike, to be familiar with use of dupilumab to better facilitate treatment discussions and provide optimal patient care. In this study, we quantify dupilumab’s national use and cost by surveying the Medicare Part D Prescriber dataset. Additionally, we tabulated the total number of claims and beneficiaries over a 3 year period, as well as the characteristics of prescribers with >11 annual claims.
During the study period, the total number of Medicare Part D claims for dupilumab and the total number of beneficiaries increased by 72,778 and 11,187, respectively (Table 1). The mean cost per fill remained steady, about $3,000 over the 3-year period. The total cost of claims increased exponentially, starting at 26.6 million in 2017 and reaching 265.7 million in 2019. There was also an increasing trend toward high-volume prescribers, with dermatologists constituting the majority (54.7%; Table 2). However, the quickest rate of adoption was amongst pulmonologists for the treatment of moderate-to-severe asthma, with an average annual increase of 1024.7%. Geographically, the highest use of dupilumab in the US was in the southern states.2
Although the high cost did not limit its use, the increase in dupilumab use is likely due to limited effective treatment options for moderate-to-severe AD and the overall efficacy of dupilumab.2 Its increased use also reflects greater physician confidence, given numerous clinical trials and real-world evidence demonstrating dupilumab's favorable safety profile as a long-term treatment option. However, dupilumab has high direct costs, with over $260 million in 2019 in Medicare Part D claims. A recent study revealed that the mean annual pharmacy costs for dupilumab were $32,885, whereas pharmacy costs for systemic corticosteroids and immunosuppressants were $5,858 and $12,227, respectively.4
In 2017, dupilumab was Food and Drug Administration (FDA)- approved as a first-line treatment for moderate-to-severe AD, and it has demonstrated a favorable safety profile. However, it is currently the most expensive treatment for AD, averaging $30,000 per course for one year.1 A significant economic burden of AD exists, and it is important for healthcare providers, both dermatologists and non-dermatologists alike, to be familiar with use of dupilumab to better facilitate treatment discussions and provide optimal patient care. In this study, we quantify dupilumab’s national use and cost by surveying the Medicare Part D Prescriber dataset. Additionally, we tabulated the total number of claims and beneficiaries over a 3 year period, as well as the characteristics of prescribers with >11 annual claims.
During the study period, the total number of Medicare Part D claims for dupilumab and the total number of beneficiaries increased by 72,778 and 11,187, respectively (Table 1). The mean cost per fill remained steady, about $3,000 over the 3-year period. The total cost of claims increased exponentially, starting at 26.6 million in 2017 and reaching 265.7 million in 2019. There was also an increasing trend toward high-volume prescribers, with dermatologists constituting the majority (54.7%; Table 2). However, the quickest rate of adoption was amongst pulmonologists for the treatment of moderate-to-severe asthma, with an average annual increase of 1024.7%. Geographically, the highest use of dupilumab in the US was in the southern states.2
Although the high cost did not limit its use, the increase in dupilumab use is likely due to limited effective treatment options for moderate-to-severe AD and the overall efficacy of dupilumab.2 Its increased use also reflects greater physician confidence, given numerous clinical trials and real-world evidence demonstrating dupilumab's favorable safety profile as a long-term treatment option. However, dupilumab has high direct costs, with over $260 million in 2019 in Medicare Part D claims. A recent study revealed that the mean annual pharmacy costs for dupilumab were $32,885, whereas pharmacy costs for systemic corticosteroids and immunosuppressants were $5,858 and $12,227, respectively.4
