title: The impact of biologic therapy in chronic plaque psoriasis from a societal perspective: an analysis based on Italian actual clinical practice.
abstract: OBJECTIVE
  Psoriasis is one of the most common forms of chronic dermatitis, affecting 2-3% of the worldwide population. It has a serious effect on the way patients perceive themselves and others, thereby prejudicing their quality of life and giving rise to a significant deterioration in their psycho-physical well-being; it also poses greater difficulties for them in leading a normal social life, including their ability to conduct a normal working life. All the above-mentioned issues imply a cost for the society. This study proposes to evaluate the impact on societal costs for the treatment of chronic plaque psoriasis with biologics (etanercept, infliximab and adalimumab) in the Italian clinical practice.
  
  
  METHODS
  A prospective observational study has been conducted in 12 specialized centres of the Psocare network, located throughout Italy. Direct and indirect costs (as well as the health-related quality of life of patients with plaque psoriasis undergoing biologic treatments) have been estimated, while the societal impact has been determined using a cost-utility approach.
  
  
  RESULTS
  Non-medical and indirect costs account for as much as 44.97% of the total cost prior to treatment and to 6.59% after treatment, with an overall 71.38% decrease. Adopting a societal perspective in the actual clinical practice of the Italian participating centres, the ICER of biologic therapies for treating plaque psoriasis amounted to €18634.40 per QALY gained--a value far from the €28656.30 obtained by adopting a third-party payer perspective.
  
  
  CONCLUSIONS
  Our study confirms that chronic psoriasis subjects patients to a considerable burden, together with their families and caregivers, stressing how important it is to take the societal perspective into consideration during the appraisal process. Besides, using data derived from Italian actual practice, treatment with biologics shows a noteworthy benefit in social terms.
authors.affiliation: Tor Vergata University of Rome, Rome, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Polistena
authors.affiliation: Department of Dermatology, Spedali Civili, Brescia, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Calzavara-Pinton
authors.affiliation: Department of Dermatology, University of Milan, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Altomare
authors.affiliation: San Gallicano Dermatological Institute, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Berardesca
authors.affiliation: Department of Medicine, Dermatology and Venereology Sector, University of Verona, Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Girolomoni
authors.affiliation: Unit of Dermatology, Lucca Hospital, Lucca, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Martini
authors.affiliation: Unit of Dermatology, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Peserico
authors.affiliation: Department of Dermatology, Messina Hospital, Messina, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Puglisi Guerra
authors.affiliation: Tor Vergata University of Rome, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Spandonaro
authors.affiliation: Unit of Dermatology and Venereology, University of Bari, Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Vena Gino
authors.affiliation: Department of Dermatology, Tor Vergata University of Rome, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Chimenti
authors.affiliation: Department of Dermatology, Federico II University of Naples, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ayala
mesh_terms: D000068879:Adalimumab / Q000191:economics / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use; D001688:Biological Products / Q000191:economics* / Q000627:therapeutic use*; D002908:Chronic Disease; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D016527:Drug Costs / Q000706:statistics & numerical data*; D000068800:Etanercept / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000191:economics / Q000627:therapeutic use; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics*; D019057:Quality-Adjusted Life Years; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001688:Biological Products; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept