Cost-of-illness in patients with moderate to severe psoriasis: a cross-sectional survey in Hungarian dermatological centres

• Published in: The European journal of health economics Vol. 15; no. Suppl 1; pp. S101 - S109
• Main Authors: Balogh, Orsolya, Brodszky, Valentin, Gulácsi, László, Herédi, Emese, Herszényi, Krisztina, Jókai, Hajnalka, Kárpáti, Sarolta, Baji, Petra, Remenyik, Éva, Szegedi, Andrea, Holló, Péter
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer 01.05.2014; Springer Berlin Heidelberg; Springer Nature B.V
• Subjects: Adaptation, Psychological; Adult; Aged; Ambulatory Care - economics; Biological products; Biological Products - economics; Biological Products - therapeutic use; Biological treatment; Cost analysis; Cost of Illness; Cross-Sectional Studies; Dermatology; Diabetes; Economic Policy; Employment; Epidemiology; Female; Health care costs; Health care expenditures; Health Care Management; Health care utilization; Health Economics; Human capital; Humans; Hungary; Illnesses; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Patients; Pharmaceuticals; Pharmacoeconomics and Health Outcomes; Prescription drugs; Psoriasis; Psoriasis - classification; Psoriasis - economics; Psoriasis - therapy; Public Finance; Public Health; Quality of Life; Questionnaires; Severity of Illness Index; Skin diseases; Studies; Surveys and Questionnaires; Tariffs; Total costs; Hungary; Biological treatments; Psoriasis; I190; Cost-of-illness; Quality of life
• ISSN: 1618-7598; 1618-7601
• DOI: 10.1007/s10198-014-0599-z

Background Despite the widespread availability of biological drugs in psoriasis, there is a shortage of disease burden studies. Objectives To assess the cost-of-illness and quality of life of patients with moderate to severe psoriasis in Hungary. Methods Consecutive patients with Psoriasis Area and Severity Index (PASI) > 10 and Dermatology Life Quality Index (DLQI) > 10, or treated with traditional systemic (TST) or biological systemic treatment (BST) were included. Demographic data, clinical characteristics, psoriasis related medication, health care utilizations and employment status in the previous 12 months were recorded. Costing was performed from the societal perspective applying the human capital approach. Quality of life was assessed using DLQI and EQ-5D measures. Results Two-hundred patients were involved (females 32 %) with a mean age of 51 (SD 13) years, 103 (52 %) patients were on BST. Mean PASI, DLQI and EQ-5D scores were 8 (SD 10), 6 (SD 7) and 0.69 (SD 0.3), respectively. The mean total cost was €9,254/patient/year (SD 8,502) with direct costs accounting for 86 %. The main cost driver was BST (mean €7,339/patient/year). Total costs differed significantly across treatment subgroups, mean (SD): no systemic therapy €2,186 (4,165), TST €2,388 (4,106) and BST €15,790 (6,016) (p < 0,001). Patients with BST had better PASI and DLQI scores (p < 0.01) than the other two subgroups. Conclusions Patients with biological treatment have a significantly better quality of life and higher total costs than patients with or without traditional systemic treatment. Our study is the largest in Europe and the first in the CEE region that provides cost-of-illness data in psoriasis involving patients with BST.