Health care resource use, productivity, and costs among patients with moderate to severe plaque psoriasis in the United States
Authors: Caroline P. Schaefer, Joseph C. Cappelleri, Rebecca Cheng, Jason C. Cole, Scott Guenthner, Joseph Fowler, Sandy Johnson, Carla Mamolo
Journal: Journal of the American Academy of Dermatology (2015)

BackgroundComprehensive studies on costs of moderate to severe plaque psoriasis (MSPP) have not been conducted in the United States.ObjectiveWe sought to evaluate current health care resource use, productivity, and costs among patients with MSPP in routine practice.MethodsA total of 200 adults seeking MSPP treatment enrolled in 9 US sites. Consented patients reported symptoms, treatment, lost productivity, and costs; 6-month retrospective chart review captured health care resource use and clinical characteristics. Costs were assigned to health care resource use and lost productivity using standard algorithms. Differences by Psoriasis Area and Severity Index (PASI) group, based on PASI score (≤10, >10-≤20, >20) at enrollment, were evaluated. Analyses included descriptive statistics and analysis of variance or Kruskal-Wallis tests.ResultsMost patients (79.5%) were prescribed 1 or more MSPP medications (mean: 1.5); 36.0% and 9.0% received self-administered biologics and systemic therapies, respectively. Mean number of nonprescription treatments was 12.3. Differences by PASI group were observed for overall work and activity impairment (P < .02). Six-month total MSPP direct costs per patient were $11,291; indirect costs were $2101 and differed across PASI groups (P = .0008).LimitationsThis study enrolled patients with MSPP actively seeking care.ConclusionDespite treatment, a number of patients with MSPP continue to experience moderate to severe PASI scores, impaired functioning, and high costs suggesting a need for new treatment options. Comprehensive studies on costs of moderate to severe plaque psoriasis (MSPP) have not been conducted in the United States. We sought to evaluate current health care resource use, productivity, and costs among patients with MSPP in routine practice. A total of 200 adults seeking MSPP treatment enrolled in 9 US sites. Consented patients reported symptoms, treatment, lost productivity, and costs; 6-month retrospective chart review captured health care resource use and clinical characteristics. Costs were assigned to health care resource use and lost productivity using standard algorithms. Differences by Psoriasis Area and Severity Index (PASI) group, based on PASI score (≤10, >10-≤20, >20) at enrollment, were evaluated. Analyses included descriptive statistics and analysis of variance or Kruskal-Wallis tests. Most patients (79.5%) were prescribed 1 or more MSPP medications (mean: 1.5); 36.0% and 9.0% received self-administered biologics and systemic therapies, respectively. Mean number of nonprescription treatments was 12.3. Differences by PASI group were observed for overall work and activity impairment (P < .02). Six-month total MSPP direct costs per patient were $11,291; indirect costs were $2101 and differed across PASI groups (P = .0008). This study enrolled patients with MSPP actively seeking care. Despite treatment, a number of patients with MSPP continue to experience moderate to severe PASI scores, impaired functioning, and high costs suggesting a need for new treatment options.