Costs and quality of life in patients with moderate to severe plaque-type psoriasis in Germany: A multi-center study

BACKGROUND

This study evaluated costs, disease severity and health-related quality of life (QoL) in patients with moderate to severe plaque-type psoriasis.

PATIENTS AND METHODS

Patients with a 'psoriasis area and severity index' (PASI) > 12 and/or a body surface area (BSA) > 10 were enrolled in dermatological practices and hospital outpatient departments (n = 184) and the total costs of illness generated during the last 12 months were retrospectively calculated. QoL was assessed using the SF-36 and the DLQI. Participants were stratified into three subgroups according to the treatment received during the 1 year documentation period; a) patients without and b) patients with phototherapy or standard systemic therapy, and c) patients who had failed, were intolerant or had contraindications to at least two standard systemic therapies. The study was performed before biologics became available for the treatment of psoriasis in Germany.

RESULTS

Included patients had severe skin symptoms (mean PASI 18.2) and a highly impaired QoL (mean DLQI 10.6). Total annual costs amounted to euro 6,709. Patients belonging to subgroup C had the most severe skin symptoms (mean PASI 22.2), the lowest QoL (mean DLQI 12.6), the highest hospitalization rate and largest loss of productivity. These patients produced the highest total costs of 8.831 euro/y.

CONCLUSIONS

Patients who cannot (or can no longer) be adequately managed with standard treatments are characterized by high disease activity, high costs and reduced QoL. Improved treatment options particularly for these patients are medically necessary and appear economically sensible.

A prospective evaluation of the cost of psoriasis in Spain (EPIDERMA project: phase II)

OBJECTIVE

To estimate the direct and indirect costs related to psoriasis in Spain.

METHODS

We performed a 12-month, multicentre, prospective longitudinal and observational study. Overall expense of care was assessed as the sum of direct and indirect costs.

RESULTS

A total of 797 patients with varying demographics and different degrees of severity of psoriasis were included in the study. The mean total cost of psoriasis, including direct and indirect items, was 1,079 euro per patient and year. The major sources of expenditure were prescription drugs (46.6%), followed by medical activities (34.5%). Mean costs in patients with moderate and severe psoriasis were approximately 1.5 and 2.5 times higher than in those with mild psoriasis, respectively.

CONCLUSIONS

In Spain, psoriasis is associated with substantial costs both to the National Health System and to the patients.

Work Limitations and Productivity Loss Are Associated with Health-Related Quality of Life but Not with Clinical Severity in Patients with Psoriasis

BACKGROUND

According to current guidelines the cost of productivity loss should be considered in pharmacoeconomic analyses. The cost of health-related productivity loss in psoriasis patients is unknown.

OBJECTIVE

To estimate the cost of productivity loss in psoriasis and its association with health-related quality of life and clinical disease severity.

METHODS

Cross-sectional study, recruitment of adult participants through Internet advertisements. 201 (72.3%) out of 278 eligible participants completed the study. Health-related work productivity loss, quality of life and clinical severity of psoriasis were assessed by standardized instruments.

RESULTS

Indirect costs of productivity loss clearly exceed the total direct cost. In contrast to objective clinical disease severity, health-related quality of life (measured by the Dermatology Life Quality Index) is an independent predictor of work productivity.

CONCLUSIONS

There is good reason to believe that intervention can reduce health-related productivity loss by improving patients' quality of life. Savings from increased work productivity might offset comparatively high acquisition costs of biological agents.

Cost of Moderate to Severe Plaque Psoriasis in Germany: A Multicenter Cost-of-Illness Study

BACKGROUND

There is little information concerning the costs of psoriasis and patients' quality of life (QoL) in Germany.

OBJECTIVE

To obtain data on the annual costs and QoL(to follow in a further publication) of patients with moderate to severe plaque psoriasis.

METHODS

Between October 2003 and February 2004, six office-based dermatologists and eight dermatology outpatient departments retrospectively documented cost-of-illness data from a societal cost perspective in 184 patients over a 12-month period. Patients were stratified into three subgroups according to their treatment scheme.

RESULTS

Mean total costs amounted to euro 6,709 per patient and year. The mean PASI score was 18.2 and PBSA 28.9%. Annual costs were highest with euro 8,831 in high-need patients. They also showed the highest PASI score (22.2).

CONCLUSION

Moderate to severe plaque psoriasis is associated with tremendous costs, particularly in patients not adequately controlled by conventional therapies, while the outcomes of patients were unsatisfactory.

Cost-of-illness in patients with moderate and severe chronic psoriasis vulgaris in Germany

BACKGROUND

Data regarding costs of outpatient and office-based care, as well as out-of-pocket expenses, for psoriasis patients in Germany are not available. Aim of this study was to assess average annual cost and cost per flare of outpatient and office-based care for patients with moderate to severe chronic psoriasis vulgaris from several perspectives.

METHODS

In this multi-center, cross-sectional, retrospective and prospective cost-of-illness study, direct (medical and non-medical) and indirect costs were considered from patient, third-party payer (TPP) and societal perspectives.

RESULTS

Out of 227 patients enrolled consecutively in 17 centers, 192 cases could be analyzed. On average, TPP reimbursed 864 per patient annually, 60 % for prescribed medication and 22 % for hospitalization. Patients spent 596 yearly mainly for alternative therapies and OTC-medication/skin care products as well as for additional expenses (e. g. ultraviolet lamp, clothes or cleaning agents). Indirect costs per patient amounted to 1,440 yearly. Total annual costs per patient were 2,866 and 4,985 if treated with systemic drugs additionally. 1,173 if treated topically and/or with phototherapy.

CONCLUSIONS

The relatively high average annual costs per patient indicate need for efficient control of psoriasis. This cost-of-illness study provides basic data for further decision making, including economic assessment of innovative therapies for psoriasis.