Expert Consensus on Real-World Use and Consumption Patterns of a Fixed-Dose Combination Foam for Psoriasis as a Reactive Management (RM) and Proactive Management (PAM) Regimen

Expert Consensus on Real-World Use and Consumption Patterns of a Fixed-Dose Combination Foam for Psoriasis as a Reactive Management (RM) and Proactive Management (PAM) Regimen

Introduction Plaque psoriasis is a chronic skin disease characterised by periods of remission and relapse and associated with considerable burden to patients and healthcare systems. For most patients, standard-of-care is reactive management (RM) with topical therapies, but, more recently, the benefi...

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Bibliographic Details
Published in:Advances in therapy Vol. 40; no. 3; pp. 1062 - 1073
Main Authors: Perry, Richard, Beveridge, Abigail J., Sears, Amy J., Rasmussen, Elisabeth R.
Format: Journal Article
Language:English
Published: Cheshire Springer Healthcare 01-03-2023
Subjects:
Betamethasone - therapeutic use
Cardiology
Consensus
Dermatologic Agents
Drug Combinations
Endocrinology
Humans
Internal Medicine
Medicine
Medicine & Public Health
Oncology
Original Research
Pharmacology/Toxicology
Psoriasis - complications
Rheumatology
Surveys and Questionnaires
Treatment Outcome
Consumption
Plaque psoriasis
Flare treatment
Proactive management (PAM)
Reactive management (RM)
Long-term maintenance treatment
Calcipotriol and betamethasone dipropionate (Cal/BD) foam
Real-world experience
Delphi
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Summary:Introduction Plaque psoriasis is a chronic skin disease characterised by periods of remission and relapse and associated with considerable burden to patients and healthcare systems. For most patients, standard-of-care is reactive management (RM) with topical therapies, but, more recently, the benefits of proactive management (PAM) have been recognised. This study aimed to gain consensus on real-world use and consumption in RM versus PAM regimens, based on fixed-dose combination calcipotriol and betamethasone dipropionate (Cal/BD) foam which, following a recent update, is currently the only topical therapy for psoriasis with a long-term maintenance regimen in its label. Methods The modified-Delphi approach was used to gain insights and consensus on real-world views, use and consumption in RM versus PAM from a panel of dermatologists with experience prescribing Cal/BD foam as PAM. The panel included 16 dermatologists, 4 each from France, Germany, Italy, and Spain, and included two questionnaire rounds and a meeting to obtain final consensus. Results The panel agreed that topicals are burdensome to apply in clinical practice and that poor patient adherence, particularly long-term, is a barrier to effective psoriasis management. The panel advised that, as they prescribe a similar number of cans for RM and PAM over a given period, consumption is not a key driver influencing future decisions to prescribe PAM, even in instances where prescribing differences could be observed. Instead, the panel agreed that patient- and disease-related factors better determine patient suitability for PAM. Conclusion This modified-Delphi study confirms that prescription of RM or PAM, with Cal/BD foam, is largely driven by patient-related factors and patient involvement is key to optimise outcomes. Real-world experiences captured in this study suggest that a PAM regimen does not increase overall consumption, and thus costs per patient for payers and prescribers, in comparison to RM.
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ISSN:0741-238X
1865-8652
DOI:10.1007/s12325-022-02417-6