(022) Market Uptake and Pattern of Use of Emerging Topical Rosacea Medications in Switzerland: a Descriptive Study using Swiss Claims Data

Background: Rosacea is a chronic inflammatory facial skin and ocular disease. In Switzerland, topical metronidazole was the only first-line topical treatment for rosacea, until topical brimonidine was licensed in 2014 and topical ivermectin in 2016.

Objectives: To evaluate the use of topical medications specifically indicated for rosacea between 2015 and 2021 in Switzerland.

Methods: We used claims data from the Swiss health insurance ‘Helsana’ between January 2015 and December 2021 (study period). We quantified the period prevalence of treated rosacea in Switzerland, overall and stratified by age (≥/ < 50 y) and sex. Therefore, we identified all persons with at least one claim of either topical metronidazole, brimonidine, or ivermectin, divided by all continuously enrolled persons during the study period. We also quantified the yearly prevalence of treated rosacea among persons insured during the entire calendar year. We quantified the proportion of patients with monotherapy or with combinations of these rosacea treatments, as well as the proportion of rosacea patients with claims for topical corticosteroids within the same calendar year.

Results: The period prevalence of treated rosacea was 3.0% (22,470 / 749,598) between 2015 and 2021. Of all rosacea patients, 70% were female and 71% were aged ≥50 years. The yearly prevalence of treated rosacea increased from 0.52% in 2015 to 0.62% in 2021. Metronidazole was used by 95% and 93% of all treated rosacea patients in 2015 and 2016 and then continuously dropped to 63% in 2021. Ivermectin was claimed by 24% in 2017 and increased to 41% in 2021. The proportion of topical monotherapy for rosacea did not change much during the study period with 92% in 2015 and 88% in 2021. However, while metronidazole monotherapy accounted for 92% of all rosacea patients, it decreased to 55% in 2021, whereas ivermectin monotherapy accounted for 33%. Only between 4% and 6% of all rosacea patients combined metronidazole and ivermectin in the same year. Brimonidine was claimed by < 10% of all treated rosacea patients mainly as monotherapy throughout. Topical corticosteroids were claimed by 31% of all treated rosacea patients in 2015, which did not change during the study period (29% in 2021).

Conclusions: The discrepancy between yearly and period prevalence suggests that many rosacea patients receive intermittent therapy. Despite the decline in use, metronidazole monotherapy remains the most frequently used topical rosacea treatment in Switzerland. However, use of ivermectin is continuously increasing, while brimonidine accounts for a small and stable proportion of use. Although contraindicated for rosacea, almost one third of rosacea patients also claimed topical corticosteroids in the same year, but the indication for the steroid treatment is unknown.