Cost-of-illness in patients with moderate to severe psoriasis: a cross-sectional survey in Hungarian dermatological centres.
BACKGROUND
Despite the widespread availability of biological drugs in psoriasis, there is a shortage of disease burden studies.


OBJECTIVE
To assess the cost-of-illness and quality of life of patients with moderate to severe psoriasis in Hungary.


METHODS
Consecutive patients with Psoriasis Area and Severity Index (PASI) > 10 and Dermatology Life Quality Index (DLQI) > 10, or treated with traditional systemic (TST) or biological systemic treatment (BST) were included. Demographic data, clinical characteristics, psoriasis related medication, health care utilizations and employment status in the previous 12 months were recorded. Costing was performed from the societal perspective applying the human capital approach. Quality of life was assessed using DLQI and EQ-5D measures.


RESULTS
Two-hundred patients were involved (females 32%) with a mean age of 51 (SD 13) years, 103 (52%) patients were on BST. Mean PASI, DLQI and EQ-5D scores were 8 (SD 10), 6 (SD 7) and 0.69 (SD 0.3), respectively. The mean total cost was €9,254/patient/year (SD 8,502) with direct costs accounting for 86%. The main cost driver was BST (mean €7,339/patient/year). Total costs differed significantly across treatment subgroups, mean (SD): no systemic therapy €2,186 (4,165), TST €2,388 (4,106) and BST €15,790 (6,016) (p < 0,001). Patients with BST had better PASI and DLQI scores (p < 0.01) than the other two subgroups.


CONCLUSIONS
Patients with biological treatment have a significantly better quality of life and higher total costs than patients with or without traditional systemic treatment. Our study is the largest in Europe and the first in the CEE region that provides cost-of-illness data in psoriasis involving patients with BST.
Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary.
Orsolya
O
Balogh
Valentin
V
Brodszky
László
L
Gulácsi
Emese
E
Herédi
Krisztina
K
Herszényi
Hajnalka
H
Jókai
Sarolta
S
Kárpáti
Petra
P
Baji
Éva
É
Remenyik
Andrea
A
Szegedi
Péter
P
Holló
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D001688:Biological Products / Q000191:economics* / Q000627:therapeutic use; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000145:classification / Q000191:economics* / Q000628:therapy; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D001688:Biological Products