title: Efficacy and cost of etanercept in long-term psoriasis: Rational use in clinical practice.
abstract: BACKGROUND
  The advent of the biological therapies has led health expenditure in dermatology units. This study aims to evaluate, in our regular clinical practice, the patterns of use of etanercept and its influence on efficacy and safety outcomes, as well as the real costs associated with continuous and intermittent treatment regimens.
  
  
  METHODS
  Observational, retrospective, non-interventionist, and multicenter study to analyze the experience of the treatment with etanercept in the management of moderate-to-severe plaque psoriasis, given according to the daily clinical practice of the Dermatology Departments of the Complejo Hospitalario de Jaén and the Hospital Universitario Virgen del Rocío (Seville).
  
  
  RESULTS
  83.3% (n = 45) of the 54 patients included in our study received the continuous regimen of Etanercept, whereas 16.7% (n = 9) were given the intermittent regimen. 94.4% (n = 51) of the patients studied began the Etanercept treatment at a dose of 50 mg/week. The mean patient/year cost of the study population is €11 298.80 (95%CI €10 551.40-€12 046.20). Breaking down the first and the second year of treatment by regimen, in the continuous regimen the mean cost would be €12 294.15 and €12 327.05 in the first and the second year, respectively, and €10 302.07 and €4986.51 in the intermittent regimen.
  
  
  CONCLUSIONS
  Etanercept is a biologic that had demonstrated its versatility over the years and permits the individualization of treatment in our patients, thus having a direct impact on drug-related costs. This is well demonstrated in our series, where 94.4% of our patients begin with the dose of 50 mg/d. Our study yields relatively higher figures in patients on continuous therapy, with 77.1% of them maintaining PASI75 at week 24.
  
  
  CONCLUSIONS
  We present our experience in regular clinical practice with etanercept, showing it to be an effective, safe, and versatile drug that permits patient-tailored treatment, delivering a frankly satisfactory control of our psoriasis patients.
authors.affiliation: a Dermatology Unit , Hospital Universitario Virgen de las Nieves , Granada , Spain .
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ruiz-Villaverde
authors.affiliation: b Dermatology Unit , Complejo Hospitalario de Jaen , Jaen , Spain , and.
authors.forename: Manuel
authors.initials: M
authors.lastname: Galán-Gutierrez
authors.affiliation: c Dermatology Unit , Hospital Virgen del Rocio , Sevilla , Spain.
authors.forename: Roman
authors.initials: R
authors.lastname: Barabash-Neila
authors.affiliation: c Dermatology Unit , Hospital Virgen del Rocio , Sevilla , Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Rodriguez-Fernandez-Freire
authors.affiliation: c Dermatology Unit , Hospital Virgen del Rocio , Sevilla , Spain.
authors.forename: Julian
authors.initials: J
authors.lastname: Conejo-Mir
mesh_terms: D000328:Adult; D001691:Biological Therapy / Q000191:economics / Q000379:methods; D016527:Drug Costs; D000068800:Etanercept / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics; D012189:Retrospective Studies
chemical_list: D000068800:Etanercept
keywords: Clinical practice; cost; etanercept; psoriasis; treatment