It is possible that this rise in Medicare claims reflects the utility of tacrolimus in this population, and that the sustained upward trend is predictive of a growing role for topical calcineurin inhibitors with elderly patients.5 Additionally, the increase in claims following generic availability may underscore how brand name drug cost acts as a barrier to prescriptions. Of note, this study is limited by a lack of causality. We were also limited by an inability to filter data based on formulation, and by the fact that the Medicare population is heterogenous and does not include all elderly in the US. Further analysis of these trends will be necessary to fully understand the factors that underlie the use of topical calcineurin inhibitors and their role in the Medicare population.
DISCLOSURES
David Rosmarin MD has received honoraria as a consultant for
AbbVie, Abcuro, AltruBio, Boehringer-Ingelheim, Bristol Meyers
Squibb, Celgene, Concert, Dermavant, Dermira, Incyte, Janssen,
Kyowa Kirin, Lilly, Novartis, Pfizer, Regeneron, Sanofi, Sun
Pharmaceuticals, UCB, VielaBio; has received research support
from AbbVie, Amgen, Bristol Meyers Squibb, Celgene, Dermira,
Galderma, Incyte, Janssen, Lilly, Merck, Novartis, Pfizer, and
Regeneron Pharmaceuticals Inc; and has served as a paid
speaker for AbbVie, Amgen, Celgene, Janssen, Lilly, Novartis,
Pfizer, Regeneron Pharmaceuticals Inc., and Sanofi. The other
authors have no conflicts of interest to declare. IRB approval
status: exempt.
REFERENCES
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2. Fiorillo L, Marcoux D, Ramien M. Contemporary role of topical calcineurin inhibitors: a pediatric dermatology perspective. J Cutan Med Surg. 2019;23(4_suppl):11S-18S. doi:10.1177/1203475419857975
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5. Meurer M, Lubbe J, Kapp A, Schneider D. The role of pimecrolimus cream 1% (Elidel)) in managing adult atopic eczema. Dermatology. 2007;215 Suppl 1:18-26. doi:10.1159/000102117
2. Fiorillo L, Marcoux D, Ramien M. Contemporary role of topical calcineurin inhibitors: a pediatric dermatology perspective. J Cutan Med Surg. 2019;23(4_suppl):11S-18S. doi:10.1177/1203475419857975
3. Pariser DM. Topical steroids: a guide for use in the elderly patient. Geriatrics. 1991;46(10):51-63.
4. Coyle D, Barbeau M. Cost effectiveness of Elidel in the management of patients with atopic dermatitis in Canada. J Cutan Med Surg. 2004;8(6):405- 410. doi:10.1007/s10227-004-0111-y
5. Meurer M, Lubbe J, Kapp A, Schneider D. The role of pimecrolimus cream 1% (Elidel)) in managing adult atopic eczema. Dermatology. 2007;215 Suppl 1:18-26. doi:10.1159/000102117
AUTHOR CORRESPONDENCE
David Rosmarin MD drosmarin@tuftsmedicalcenter.org
