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Maravilla-Herrera P, Merino M, Alfonso Zamora S, Balea Filgueiras J, Carrascosa Carrillo JM, Delgado Sánchez O, Dolz Sinisterra F, García-Ruiz A, Herranz Pinto P, Manfredi A, Martínez Olmos J, Morales de los Ríos Luna P, Puig L, Ros S, Hidalgo-Vega Á. The social value of a PASI 90 or PASI 100 response in patients with moderate-to-severe plaque psoriasis in Spain. Front Public Health 2023; 11:1000776. [PMID: 36778548 PMCID: PMC9909187 DOI: 10.3389/fpubh.2023.1000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction Psoriasis is a chronic disease involving the skin, which significantly impacts the quality of life. Disease severity and treatment efficacy (i.e., response) are assessed through the Psoriasis Area and Severity Index (PASI). A PASI 75 response, i.e., an improvement of at least 75% with respect to the baseline PASI score, has traditionally been used as a therapeutic benchmark in clinical trials. Therapeutic advances have made PASI 90 or PASI 100 responses possible in most patients treated with some biologics. A greater response may generate social value beyond clinical outcomes that would benefit both patients and society. Methods A 1-year economic model was applied to estimate the impact of having a PASI 75, PASI 90, or PASI 100 response in four areas of analysis (quality of life, activities of daily living, work productivity, and out-of-pocket expenditures) and the social value of having a PASI 90 or PASI 100 response in comparison with a PASI 75 response. A mixed-methods approach based on the scientific literature, a focus group with patient, and an advisory committee with psoriasis stakeholders was used. The model included three different scenarios: having a PASI 90 vs a PASI 75 response; a PASI 100 vs a PASI 90 response; and a PASI 100 vs a PASI 75 response. A sensitivity analysis was included. Results The annual economic impact per patient with moderate-to-severe plaque psoriasis having a PASI 75 response was estimated at Ł 6,139, mainly related to labour productivity losses and quality of life reductions. Having a PASI 90 or a PASI 100 response would reduce this impact to €3,956 or €1,353, respectively. Accordingly, the social value of having a PASI 90 instead of a PASI 75 response was estimated at €2,183, and €4,786 with a PASI 100 response. Discussion A PASI 90 or PASI 100 response would have a lower economic impact and a greater social value than a PASI 75 response for patients with moderate-to-severe plaque psoriasis.
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Affiliation(s)
| | - María Merino
- Department of Health Outcomes Research, Weber, Madrid, Spain,*Correspondence: María Merino ✉
| | - Santiago Alfonso Zamora
- Department of Management, Psoriasis and Psoriatic Arthritis Patient and Family Association (Acción Psoriasis), Barcelona, Spain
| | | | | | - Olga Delgado Sánchez
- Department of Management, Spanish Society of Hospital Pharmacy (SEFH), Madrid, Spain,Department of Pharmacy, Son Espases University Hospital, Illes Balears, Spain
| | | | - Antonio García-Ruiz
- Health Economics and Rational Use of Medicines, Department of Pharmacology and Clinical Therapeutics, Biomedical Research Institute of Malaga (IBIMA), University of Malaga, Malaga, Spain
| | | | - Antonio Manfredi
- Department of Management, Psoriasis and Psoriatic Arthritis Patient and Family Association (Acción Psoriasis), Barcelona, Spain
| | | | | | - Lluís Puig
- Department of Dermatology, Santa Creu i Sant Pau Hospital, Barcelona, Spain,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sandra Ros
- Psychologist, Departments of Dermatology and Rheumatology, and Cardiac Transplant Unit, Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - Álvaro Hidalgo-Vega
- Department of Economic Analysis and Finances, University of Castilla-La Mancha, Toledo, Spain,Fundación Weber, Madrid, Spain
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