The cost of psoriasis therapies: considerations for therapy selection.
OBJECTIVE
The purpose of this article is to provide a review of the cost of psoriasis therapies from two sources as well as compare the average wholesale price (AWP), as listed in the 2003 Drug Topics Red Book to that of a popular Internet pharmacy.


METHODS
Prices of therapies were obtained two ways: the AWP was recorded from the 2003 Drug Topics Red Book. A range and average price per gram (or mL) were calculated based on the smallest size or quantity available. In addition, a price comparison was made to values as they were reported online at drugstore.com. Monthly cost estimates were based on average systemic dosing and for topicals, 18 g/month (for 1% body surface area [BSA] involvement).


RESULTS
The prices of psoriatic treatment medications vary considerably--from the relatively inexpensive topical corticosteroids to the more costly biologic therapies. In the category of corticosteroids, a trend was evident between the overall price per gram of each class and the potency of each class. Class I and VI corticosteroids had an average price per gram (or mL) of dollars 2.08 (dollars 37/month/1% BSA) and dollars 0.86 (dollars 15/month/1% BSA), respectively. Nonsteroidal topical treatments had an average price per gram (or mL) dollars 2.18 (dollars 39/month/1% BSA). Systemic therapies have a wide range of costs. The total monthly expense, based on estimated average dosing, was calculated for methotrexate, acitretin, and cyclosporine and were dollars 78.60, dollars 400.50, and dollars 735.00, respectively. Biologic therapies designed for continuous use cost roughly dollars 1,300/month.


CONCLUSIONS
There are numerous treatment options for psoriasis with a wide range of costs. In addition to significant challenges from a scientific perspective, psoriasis treatment is further complicated by the cost of the numerous medications. Prices reported in the AWP were similar in many instances to those listed at an Internet pharmacy. Many considerations should go into therapy selection for psoriasis and a comprehensive approach that includes cost will likely provide the best patient care.
Pearce
Daniel J
DJ
Wake Forest University School of Medicine, Department of Dermatology, Winston-Salem, NC, USA.
Thomas
Crystal G
CG
Fleischer
Alan B
AB
Feldman
Steven R
SR
D000893:Anti-Inflammatory Agents / Q000145:classification / Q000191:economics; D003363:Cost Control; D003362:Cost-Benefit Analysis; D003879:Dermatologic Agents / Q000145:classification / Q000191:economics; D016527:Drug Costs / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics; D018579:Patient Selection; D010789:Phototherapy / Q000191:economics; D011565:Psoriasis / Q000628:therapy*; D012051:Reimbursement Mechanisms / Q000191:economics; D013810:Therapeutic Equivalency
D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D007166:Immunosuppressive Agents