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The impact of psoriasis on health care costs and patient work loss

https://doi.org/10.1016/j.jaad.2008.06.043Get rights and content

Background

There are few comprehensive estimates of the cost of psoriasis in the United States.

Objective

We sought to quantify the incremental direct medical and indirect work loss costs associated with psoriasis.

Methods

A de-identified claims database from 31 self-insured employers during the period 1998 to 2005 was used. Patients with at least two psoriasis diagnosis claims (N = 12,280) were compared with 3 control subjects (matched on year of birth and sex) without psoriasis. Multivariate two-part regression analysis was used to isolate the incremental cost of psoriasis by controlling for comorbidities and other confounding factors.

Results

After multivariate adjustment, the incremental direct and indirect costs of psoriasis were approximately $900 and $600 (P < .001) per patient per year, respectively.

Limitations

The database used in this study does not contain information on patient out-of-pocket costs or loss of productivity costs at work.

Conclusion

The incremental cost of psoriasis is approximately $1500 per patient per year, with work loss costs accounting for 40% of the cost burden.

Section snippets

Data source

De-identified health and disability administrative claims data were used to assess the incremental cost burden associated with psoriasis. The administrative claims data cover the period January 1, 1998, through January 31, 2005, and include approximately 5.1 million employees, their spouses, and dependents from 31 large, self-insured Fortune 500 US companies. Collectively, these 31 companies have operations throughout the United States and represent a broad array of industries, including

Patient characteristics

Table I summarizes the inclusion criteria used to construct the psoriasis group. For the analysis of direct medical costs, a total of 12,280 patients with psoriasis were matched with 36,840 control subjects. For the analysis of indirect work loss costs, only active employees with work loss data were analyzed, which resulted in 3097 patients with psoriasis and 8335 control subjects.

Table II compares the mean characteristics of the psoriasis group with those of the matched control group. The

Discussion

This study provides evidence that psoriasis represents a substantial direct and indirect cost burden in the United States. Focusing specifically on a large sample of claims from 31 Fortune 500 employer-payers for the period 1998 to 2005, we estimated the incremental direct and indirect costs of psoriasis to be $5508 per patient per year using a univariate matched control analysis, and $1497 per patient per year using multivariate analysis that also controlled for the presence of comorbidities

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  • Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities

    2019, Journal of the American Academy of Dermatology
    Citation Excerpt :

    Persons with moderate or severe disease missed significantly more time from work than those with mild disease.140 Fowler et al estimated that the annual cost of lost work productivity for psoriasis patients was $5508 per patient.141 Whether treatment of psoriasis with particular medications could positively affect a patient's work abilities has been studied.

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Supported by Novartis Pharmaceuticals Corp.

Disclosure: Dr Swensen, Dr Sung, Mr Doyle, and Dr Lobo are employees of and Dr Fowler, Dr Duh, Dr Rovba, Ms Buteau, Ms Pinheiro, Mr Mallett, and Dr Kosicki are consultants to Novartis Pharmaceuticals Corp.

Presented in part at the following poster sessions: 65th Annual Meeting of the American Academy of Dermatology, Washington, DC, February 2-6, 2007, and 12th Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes Research, Arlington, VA, May 19-23, 2007.

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