title: Psoriasis causes significant economic burden to patients.
abstract: BACKGROUND
  Psoriasis results in expenses to patients from many cost sources. Psoriasis treatments may result in considerable time and traveling costs, yet many studies fail to account for these costs. The objective of this study was to evaluate the multidimensional economic burden of psoriasis to patients.
  
  
  METHODS
  The study was based on 232 Finnish patients with psoriasis or psoriatic arthritis visiting a tertiary level dermatological clinic during a 1-year study period between October 1, 2009 and September 30, 2010. The data were based on a patient questionnaire, clinical data from the medical records and reimbursement data from the Finnish Social Insurance Institution. Item costs were based on true costs charged from the patients and all time cost estimates were based on the Human Capital Approach method.
  
  
  RESULTS
  199 patients with psoriasis and 33 with psoriatic arthritis were included in the study. Total costs were higher for patients receiving traditional systemic medications or phototherapy than those not receiving such treatment. Travel costs and travel time costs accounted for more than 60% of the costs of phototherapy. Skin care at home was time consuming and thus caused significant burden to patients. The majority of the visit costs arose from hospital visits and only a small proportion were attributed to visiting primary health care providers.
  
  
  CONCLUSIONS
  Visit charges and other patient co-payments were estimated to play a minor role in the total cost of psoriasis incurred by patients, while travel costs and lost time comprised the majority of the costs, which should not be omitted in future studies regarding costs of treatments.
authors.affiliation: Department of Dermatology, Turku University Hospital and University of Turku, Lemminkäisenkatu 1, 20014 University of Turku, Turku, Finland, atmust@utu.fi.
authors.forename: A
authors.initials: A
authors.lastname: Mustonen
authors.forename: K
authors.initials: K
authors.lastname: Mattila
authors.forename: M
authors.initials: M
authors.lastname: Leino
authors.forename: L
authors.initials: L
authors.lastname: Koulu
authors.forename: R
authors.initials: R
authors.lastname: Tuominen