title: Health care resource use, productivity, and costs among patients with moderate to severe plaque psoriasis in the United States.
abstract: BACKGROUND
  Comprehensive studies on costs of moderate to severe plaque psoriasis (MSPP) have not been conducted in the United States.
  
  
  OBJECTIVE
  We sought to evaluate current health care resource use, productivity, and costs among patients with MSPP in routine practice.
  
  
  METHODS
  A total of 200 adults seeking MSPP treatment enrolled in 9 US sites. Consented patients reported symptoms, treatment, lost productivity, and costs; 6-month retrospective chart review captured health care resource use and clinical characteristics. Costs were assigned to health care resource use and lost productivity using standard algorithms. Differences by Psoriasis Area and Severity Index (PASI) group, based on PASI score (≤10, >10-≤20, >20) at enrollment, were evaluated. Analyses included descriptive statistics and analysis of variance or Kruskal-Wallis tests.
  
  
  RESULTS
  Most patients (79.5%) were prescribed 1 or more MSPP medications (mean: 1.5); 36.0% and 9.0% received self-administered biologics and systemic therapies, respectively. Mean number of nonprescription treatments was 12.3. Differences by PASI group were observed for overall work and activity impairment (P < .02). Six-month total MSPP direct costs per patient were $11,291; indirect costs were $2101 and differed across PASI groups (P = .0008).
  
  
  CONCLUSIONS
  This study enrolled patients with MSPP actively seeking care.
  
  
  CONCLUSIONS
  Despite treatment, a number of patients with MSPP continue to experience moderate to severe PASI scores, impaired functioning, and high costs suggesting a need for new treatment options.
authors.affiliation: Covance Market Access Services Inc, Gaithersburg, Maryland. Electronic address: caroline.schaefer@covance.com.
authors.forename: Caroline P
authors.initials: CP
authors.lastname: Schaefer
authors.affiliation: Pfizer Inc, Groton, Connecticut.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cappelleri
authors.affiliation: Covance Market Access Services Inc, San Diego, California.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cheng
authors.affiliation: Covance Market Access Services Inc, San Diego, California.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Cole
authors.affiliation: Dermatology Center of Indiana, Plainfield, Indiana.
authors.forename: Scott
authors.initials: S
authors.lastname: Guenthner
authors.affiliation: University of Louisville, Louisville, Kentucky.
authors.forename: Joseph
authors.initials: J
authors.lastname: Fowler
authors.affiliation: Johnson Dermatology, Fort Smith, Arkansas.
authors.forename: Sandy
authors.initials: S
authors.lastname: Johnson
authors.affiliation: Pfizer Inc, Groton, Connecticut.
authors.forename: Carla
authors.initials: C
authors.lastname: Mamolo
mesh_terms: D000041:Absenteeism; D000328:Adult; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics*; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy / Q000191:economics / Q000379:methods; D011565:Psoriasis / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D014481:United States
chemical_list: D007166:Immunosuppressive Agents
keywords: burden of illness; chart review; costs; economic burden; health care resource use; moderate to severe plaque psoriasis; observational research; productivity