The economic evaluation studied direct and indirect costs during 16 weeks of treatment and 36 weeks of follow-up, producing estimates of 1-year cumulative total costs of treatment. Direct medical costs are generated by health care utilization (medication, diagnostic procedures, and visits to health care providers). To this end, a retrospective cost-of-illness study was conducted on 120 patients treated at the University Medical Centre Mannheim between 2005 and 2006. In the US, moderate to severe psoriasis is mostly treated in an outpatient setting 7,8, while in Germany and other European countries inpatient treatment, mostly conducted as a regimen of topical dithranol combined with UV light, still is a common, but expensive therapeutic alternative 9 12. Given the rising expenses for health, economic analyses comparing the different treatment modalities are imperative. Direct medical costs were costs for inpatient treatment, outpatient medication, consultation and diagnostics as well as for skin care products. The purpose of this study was to estimate the annual and per-patient budget impact of the treatment of moderate to severe psoriasis in Greece before and after the introduction of ustekinumab. The model included drug acquisition, monitoring, and administration costs for both the induction and maintenance years for patients in a treatment mix with etanercept, adalimumab, infliximab, with or without ustekinumab. The economic analysis was performed from a national health system perspective.
Psoriasis treatments may result in considerable time and traveling costs, yet many studies fail to account for these costs. The data were based on a patient questionnaire, clinical data from the medical records and reimbursement data from the Finnish Social Insurance Institution. When assessing the health economic consequences of a disease, the perspective of patients is considered important 1, 7. In the Finnish healthcare system patients with mild psoriasis are treated in primary health care settings and only moderate to severe cases are referred to tertiary level hospitals for further treatment. Keywords: psoriasis, epidemiology, comorbidities, health services accessibility, health care disparities, insurance, health care costs. The nonavailability of treatment options for psoriasis in the public health system contradicts the Brazilian Society of Dermatology guidelines, stimulating the judicialization of access to medicines in psoriasis care. Figure 2 Algorithm of the Brazilian Society of Dermatology for moderate-to-severe psoriasis. 2,880 medicine requests for 18 different drugs were analyzed. Seasonal variation of acne and psoriasis: A 3-year study using the Physician Global Assessment severity scale. Kimball AB, Gu Y, Okun M. Treatment of moderate to severe hidradenitis suppurativa. Prevalence of skin disorders in patients seeking health care. Review of treatment options for psoriasis in pregnant or lactating women: from the Medical Board of the National Psoriasis Foundation.
Other innovative treatments are undergoing clinical studies, with the aim of maintaining safe, long-term control of the condition. Chinese herbal medicine (CHM) bath combined with phototherapy has been used in clinical settings, but the additional benefit requires evaluation. In addition, psoriasis causes significant economic burden in health care costs and losses in productivity 4. Inappropriate medication or infection may cause psoriasis vulgaris to transfer to other types of psoriasis, including erythrodermic or pustular types 1, 4. Based on a European consensus on treatment goals for moderate to severe psoriasis, PASI 50 is the minimum requirement for the efficacy of any therapy for psoriasis, but these criteria were not followed in any of the included studies 25. Osteoarthritis (OA) is a type of joint disease that results from breakdown of joint cartilage and underlying bone. Diagnosis is typically based on signs and symptoms, with medical imaging and other tests occasionally used to either support or rule out other problems. If pain interferes with normal life despite other treatments, joint replacement surgery may help. Predicting the cost-effectiveness of total hip and knee replacement: A health economic analysis.
Psoriasis Causes Significant Economic Burden To Patients