Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

Abstract

Treatment modalities of chronic plaque psoriasis have dramatically changed over the past ten years with a still continuing shift from inpatient to outpatient treatment. This development is mainly caused by outpatient availability of highly efficient and relatively well-tolerated systemic treatments, in particular BioLogicals. In addition, inpatient treatment is time- and cost-intense, conflicting with the actual burst of health expenses and with patient preferences. Nevertheless, inpatient treatment with dithranol and UV light still is a major mainstay of psoriasis treatment in Germany. The current study aims at comparing the total costs of inpatient treatment and outpatient follow-up to mere outpatient therapy with different modalities (topical treatment, phototherapy, classic systemic therapy or BioLogicals) over a period of 12 months. To this end, a retrospective cost-of-illness study was conducted on 120 patients treated at the University Medical Centre Mannheim between 2005 and 2006. Inpatient therapy caused significantly higher direct medical, indirect and total annual costs than outpatient treatment (13,042 € versus 2,984 €). Its strong influence on cost levels was confirmed by regression analysis, with total costs rising by 104.3% in case of inpatient treatment. Patients receiving BioLogicals produced the overall highest costs, whereas outpatient treatment with classic systemic antipsoriatic medications was less cost-intense than other alternatives.

Pattern of drug use in psoriasis inpatients in the department of dermatology at a tertiary care teaching hospital

“…This correlates well with the study conducted by Steinke et al 11 Of all the inpatients, an overwhelming majority were male and about a fourth of them female. Male preponderance is reported from many other Indian studies, whereas international studies do not show any such bias.…”

Coste de la psoriasis y artritis psoriásica en cinco países de Europa: una revisión sistemática

“…Todos los estudios en Ps recogieron costes directos sanitarios (farmacológicos y no farmacológicos) y en 2 de ellos se especificaron costes directos no sanitarios 22,23 . La perspectiva social se utilizó en todos los estudios, a excepción de 2, que utilizaron la perspectiva del sistema sanitario 24,25 .…”

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

“…In the COI analyses conducted by Fonia et al (UK) 353 [28] and Driessen et al (the Netherlands) [29] all patients 354 were treated with biological drugs. The biological treat-355 ment rate was 16 % in the study by Ghatnekar et al 356 (Sweden) [34], 13 % by Levy and colleagues (Canada) 357 [33], 6 % by Steinke et al (Germany) [36] [32]. Only one study by Gleason and 359 colleagues (US) did not report the rate of biological therapy 360 [31].…”

“…347 Therefore, we performed a literature search for COI studies 348 for the period from January 2010 to December 2013 using 349 the same search terms and databases as Raho et al [9].Our 350 search identified a further nine publications [28][29][30][31][32][33][34][35][36], seven 351 of which involved psoriasis patients with biological treat-352 ment. In the COI analyses conducted by Fonia et al (UK) 353 [28] and Driessen et al (the Netherlands) [29] all patients 354 were treated with biological drugs.…”