Healthcare Resource Utilization Among Patients With Generalized Pustular Psoriasis: The Impact of Flares and Disease Severity.

Background: Generalized pustular psoriasis (GPP) is a rare, chronic, often unpredictable, severe multisystemic autoinflammatory skin disease from which patients can experience flares, episodes of widespread eruptions of painful, sterile pustules often accompanied by systemic symptoms. The impact of GPP flares and underlying GPP severity on the healthcare resource utilization (HCRU) is not well characterized.

Objective: To quantify HCRU among US GPP patients by flare status and underlying severity.

Methods: Outpatient electronic health record (EHR) data (2017-2023) from the OMNY Health platform were linked with claims. Patients were indexed at first EHR GPP diagnosis code and followed for 1 year. GPP flares were identified from a previously developed algorithm. All-cause hospitalizations, emergency department/urgent care (ED/UC), and outpatient visits were summarized by flare status and underlying severity. Pharmacy and total gross charges were described by number of flares.

Results: A total of 335 patients were included. Patients who flared in the follow-up period (n = 205) had more hospitalizations than patients who did not flare (n = 130; 12.2% vs 6.9%; mean: 0.26 vs 0.09). ED/UC visits were similar between groups (22.9% vs 27.7%; mean: 0.54 vs 0.45), while outpatient visits were greater among patients who did not flare (69.8% vs 78.5%; mean: 5.37 vs 6.56). For patients with 0, 1, and ≥2 flares with HCRU, mean pharmacy charges ($19,887, $25,180, and $57,674, respectively) and total gross charges ($29,196, $40,079, and $52,940, respectively) increased monotonically.

Conclusion: GPP patients who flared and had more severe disease had greater HCRU and charges.