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Increasing Use of Tumor Necrosis Factor-Alpha Inhibitors Among Medicare Beneficiaries Despite Known Increased Risk of

Christine Learned1, Michelle Kim2, Eudora Lee2

  • 1Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.

Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]
|July 16, 2026
PubMed
Abstract

Insights

Tumor necrosis factor-alpha inhibitors (TNFis) use is rising in elderly Medicare patients, despite their known link to nonmelanoma skin cancer (NMSC). This trend may increase NMSC cases within this population.

Area of Science:

  • Immunology and Dermatology
  • Pharmacovigilance
  • Geriatric Medicine

Background:

  • Tumor necrosis factor-alpha inhibitors (TNFis) are linked to a higher risk of nonmelanoma skin cancer (NMSC).
  • Elderly individuals have the highest baseline rates of NMSC.
  • Data on TNFi use in elderly American populations are scarce.

Purpose of the Study:

  • To analyze TNFi utilization trends among Medicare beneficiaries.
  • To quantify the burden of NMSC associated with TNFi use in this demographic.

Main Methods:

  • Retrospective cohort study design.
  • Utilized Medicare Part B and D public datasets for analysis.

Main Results:

  • TNFi beneficiaries grew by 8.0% (2019-2023), with a 37.5% spending increase.
  • Medicare beneficiaries aged 65+ comprised 51.7% of TNFi claims in 2023.
  • Estimated up to 5,743 TNFi-associated NMSCs in Medicare patients in 2023.

Conclusions:

  • TNFi use has increased among elderly Medicare beneficiaries.
  • This rise persists despite established NMSC risks.
  • Continued TNFi use may lead to a higher incidence of NMSC in the Medicare population.

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