The Cost of Psoriasis and Psoriatic Arthritis in 5 European Countries: A Systematic Review.
BACKGROUND
While the introduction of biologics has improved the quality of life of patients with psoriasis and psoriatic arthritis, it may have increased the economic burden of these diseases.


OBJECTIVE
To perform a systematic review of studies on the costs associated with managing and treating psoriasis and psoriatic arthritis in 5 European countries: Germany, Spain, France, Italy, and the United Kingdom.


METHODS
We undertook a systematic review of the literature (up to May 2015) using the MEDLINE and EMBASE databases. The methodological quality of the studies identified was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. We considered both direct costs (medical and nonmedical) and indirect costs, adjusted for country-specific inflation and converted to international dollars using purchasing power parity exchange rates for 2015 ($US PPP).


RESULTS
The search retrieved 775 studies; 68.3% analyzed psoriasis and 31.7% analyzed psoriatic arthritis. The total annual cost per patient ranged from US $2,077 to US $13,132 PPP for psoriasis and from US $10,924 to US $17,050 PPP for psoriatic arthritis. Direct costs were the largest component of total expenditure in both diseases. The severity of these diseases was associated with higher costs. The introduction of biologics led to a 3-fold to 5-fold increase in direct costs, and consequently to an increase in total costs.


CONCLUSIONS
We have analyzed the economic burden of psoriasis and psoriatic arthritis and shown that costs increase with the treatment and management of more severe disease and the use of biologics.
Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, España. Electronic address: rburgos@porib.com.
R
R
Burgos-Pol
Servicio de Farmacia, Complejo Hospitalario de Toledo, Toledo, España.
J M
JM
Martínez-Sesmero
Servicio de Farmacia, Hospital Universitario Doctor Peset, Valencia, España.
J M
JM
Ventura-Cerdá
Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, España.
I
I
Elías
Celgene, S.L, Madrid, España.
M T
MT
Caloto
Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, España.
M Á
MÁ
Casado
D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D017281:Cost of Illness; D005602:France; D005858:Germany; D006801:Humans; D007558:Italy; D011565:Psoriasis / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D013030:Spain; D006113:United Kingdom
Alemania; Artritis psoriásica; Cost of disease; Coste de la enfermedad; España; France; Francia; Germany; Italia; Italy; Psoriasis; Psoriatic arthritis; Reino Unido; Review; Revisión; Spain; United Kingdom