title: The cost of biologics for psoriasis is increasing.
abstract: BACKGROUND
  Biologic agents have revolutionized the management of psoriasis but at a higher cost compared with "traditional" agents. Cost must be considered when evaluating management options for psoriasis.
  
  
  OBJECTIVE
  To estimate the annual cost of treatment of psoriasis using biologic agents and assess the trend over the past decade.
  
  
  METHODS
  The cost of annual treatment paradigms for etanercept, adalimumab, and ustekinumab was estimated using the average wholesale price. Trends were assessed by calculating the percentage change in annual cost compared with the previous year. A sales-based cost of drugs was estimated using gross US sales of each drug and an estimate of the total number of patients treated based on prescription data.
  
  
  RESULTS
  The cost of one year of induction and maintenance treatment was highest for ustekinumab ($53,909), followed by etanercept ($46,395), and adalimumab ($39,041). The sales-based cost of drugs was greatest for ustekinumab ($25,012), then adalimumab ($6,786) and etanercept ($6,629). Sales-based cost increased at an average of 20% per year.
  
  
  CONCLUSIONS
  The cost of biologic treatments for psoriasis has been increasing. Cost considerations in the management of psoriasis are likely to increase given the limited healthcare resources that are available.
authors.affiliation: Center for Dermatology Research, Departments of Dermatology, Winston-Salem, NC, USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Center for Dermatology Research, Departments of Dermatology, Winston-Salem, NC, USA ; Center for Dermatology Research, Departments of Pathology, Winston-Salem, NC, USA ; Center for Dermatology Research, Departments of Public Health, Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
keywords: adalimumab; cost analysis; etanercept; psoriasis; ustekinumab