title: Costs and quality of life in patients with moderate to severe plaque-type psoriasis in Germany: a multi-center study.
abstract: BACKGROUND
  This study evaluated costs, disease severity and health-related quality of life (QoL) in patients with moderate to severe plaque-type psoriasis.
  
  
  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.
authors.affiliation: University of Erlangen-Nuremberg, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Schöffski
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.forename: Jörg
authors.initials: J
authors.lastname: Prinz
authors.forename: Karin
authors.initials: K
authors.lastname: Rauner
authors.forename: Erich
authors.initials: E
authors.lastname: Schubert
authors.forename: Stefan
authors.initials: S
authors.lastname: Sohn
authors.forename: Kristian
authors.initials: K
authors.lastname: Reich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011565:Psoriasis / Q000145:classification / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome