There is limited evidence on the economic burden and cost effectiveness of psoriasis treatment modalities in this region. This study aims to evaluate the economic burden and cost effectiveness analysis of four Psoriasis treatment modalities in Malaysian public hospitals. This is a prospective cohort study involving a total of 523 moderate to severe psoriasis patients (Psoriasis Area Severity Index (PASI)>10and/or Body Surface Area (BSA)>10 and/or Dermatology Life Quality Life (DLQI)>10) recruited from five public hospitals in Malaysia via consecutive sampling technique. The duration of the data collection is 12 months (6 months recruitment and 6 months follow up). Inclusion criteria include new or existing moderate to severe psoriasis patients who started with new treatment modalities at the time of the recruitment period, Malaysians, aged 18 years and above and who are willing to participate. The costs are calculated from the societal perspective. Provider costs are calculated by estimating recurrent costs (emolument, consumables, utility, maintenance and training) and direct costs (drugs, laboratory investigation, procedural examination). Patient costs components are direct and indirect costs. Direct costs include treatment cost (traditional medicines), out of pocket expenses (over the counter drugs, skin supplements and products). Indirect costs covers transportation and loss of productivity. Economic burden is measured by multiplying the total cost with the prevalence of psoriasis. Effectiveness of the treatment modalities is assessed based on PASI, BSA and DLQI scores (outcomes). PASI-75 (75% reduction of PASI score from baseline score), BSA<5 and DLQI≤5 (disease has no or minimal impact on quality of life) is considered effective. The least cost per outcome is the most cost effective treatment.