Authors:

Roberto Ravasio1*, Elisabetta Rostagno2, Emanuela Zagni3, Delia Colombo3 and Paolo Dapavo2

1Health Publishing and Services, Milano, Italy

2Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy

3Patient Access Novartis Farma Italia, Novartis Farma S.p.A, Origgio, Italy

Abstract
 

Objective: 

To present an update of the cost profile of psoriasis in patients with conventional systemic therapy or biologic referring to a Center of the Piedmont Region. 

Methods: 

A retrospective, observational cohort study was conducted to estimate the cost of the treatment with conventional systemic therapy or biologic of adult patients with psoriasis referring to an Italian Center. The enrollment window started on July 1, 2017 and ended on January 31, 2018. Each patient identified was followed-up retrospectively for six months. The database collected the main details on demographics, clinical data and resource consumption (treatments administered, visits, blood tests and instrumental examinations, etc.) for each patient enrolled. The PASI index was evaluated to reconstruct the evolution over time of the seriousness of psoriasis for each patient enrolled. 

Results: 

181 patients were considered, 45.9% treated with a biologic and 54.1% with a conventional systemic therapy. During the 6 months follow-up, 2.4% patients with biologic and 11.2% with conventional systemic therapy discontinued the treatment (p=0.0233). At the beginning (baseline) a more compromised disease activity (PASI score) in patients with the biologic emerged (19.8 vs. 13.9; p=0.0005). Twelve months before enrolment the average PASI score showed a substantial overlap (5.9 vs. 5.8; p=0.9375). Upon enrollment patients treated with the biologic reported the lowest mean PASI score (2.7 vs. 3.8; p=0.1127). The 6 months cost of treatment was € 5,675 for biologic and € 321 for conventional systemic therapy (p<0.0001). The cost for the management of psoriasis was significantly higher in patients with moderate-to-severe PASI. 

Conclusions:

 The data collected seem to be sufficient to state that psoriasis is a disease with a quite high overall cost for the NHS and/or society, and that, due to its chronicity, such cost is likely to increase with the progression of severity.

Keywords:

 Psoriasis; Cost; Biologic; Conventional systemic therapy; PASI score; QALY

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