Craig A. Elmets, MD

Pinpointing treatment may help to control costs.

Psoriasis is estimated to affect 2% to 3% of the population worldwide. Because there is no cure, ongoing management is required for its control. These authors reviewed data from 35 published studies to examine the economic burden of psoriasis in North America and Europe.

As might be expected, total healthcare expenditures were greater for patients with psoriasis than for those without. Costs include both direct expenses (e.g., treatments, doctors' visits and hospitalizations) and indirect costs (e.g., lost productivity at work, early retirement — most likely due to psoriatic arthritis). Direct costs varied by country. In a U.S. study not specific for disease severity, the annual direct cost was approximated at US$1.39 billion. In Canada, the direct cost of moderate-to-severe disease alone was estimated at US$838 million. In several studies, severity of psoriasis or the PASI score was correlated with direct costs of psoriasis. At least one cause of high treatment cost was treatment failure and drug switching, which accounted for up to 17% of annual expenses. Indirect costs, though lower than direct costs, were still substantial. In the U.S., the total cost of psoriasis was estimated to be US$1.52 billion and in Canada, US$1.47 billion. These costs were equivalent to or higher than costs associated with pancreatic carcinoma, melanoma, prostate cancer, and asthma.

Citation(s):

Feldman SR et al. The economic burden of psoriasis: A systematic literature review. Expert Rev Pharmacoecon Outcomes Res. 2014 Jul 23; [e-pub ahead of print].