The impact of biologic therapy in chronic plaque psoriasis from a societal perspective: an analysis based on Italian actual clinical practice

Abstract

Objective Psoriasis is one of the most common forms of chronic dermatitis, affecting 2-3% of the worldwide population. It has a serious effect on the way patients perceive themselves and others, thereby prejudicing their quality of life and giving rise to a significant deterioration in their psycho-physical well-being; it also poses greater difficulties for them in leading a normal social life, including their ability to conduct a normal working life. All the above-mentioned issues imply a cost for the society. This study proposes to evaluate the impact on societal costs for the treatment of chronic plaque psoriasis with biologics (etanercept, infliximab and adalimumab) in the Italian clinical practice.Method A prospective observational study has been conducted in 12 specialized centres of the Psocare network, located throughout Italy. Direct and indirect costs (as well as the health-related quality of life of patients with plaque psoriasis undergoing biologic treatments) have been estimated, while the societal impact has been determined using a cost-utility approach.Results Non-medical and indirect costs account for as much as 44.97% of the total cost prior to treatment and to 6.59% after treatment, with an overall 71.38% decrease. Adopting a societal perspective in the actual clinical practice of the Italian participating centres, the ICER of biologic therapies for treating plaque psoriasis amounted to €18634.40 per QALY gained -a value far from the €28656.30 obtained by adopting a third-party payer perspective.Conclusion Our study confirms that chronic psoriasis subjects patients to a considerable burden, together with their families and caregivers, stressing how important it is to take the societal perspective into consideration during the appraisal process.Besides, using data derived from Italian actual practice, treatment with biologics shows a noteworthy benefit in social terms.

Biological therapy utilization, switching, and cost among patients with psoriasis: retrospective analysis of administrative databases in Southern Italy

“…The recent introduction of biosimilar drugs in the therapeutic armamentarium for the treatment of psoriasis could reduce costs while increasing access to biologic medications. 14 , 20 – 22 On the other hand, the arrival of new, more selective and promising molecules in terms of efficacy has also produced changes in outcome, which are more ambitious than in the past, which could have positive effects on improvement in the efficiency of treatment with a reduction in expenses in other sectors.…”

Calcipotriol/betamethasone dipropionate aerosol foam for the treatment of psoriasis vulgaris: case series and review of the literature

“…Psoriasis is a chronic, immune-mediated inflammatory disorder with a significant detrimental impact on health-related quality of life (HRQoL), 1 – 4 similar to the negative effect of other chronic conditions (eg, diabetes) on HRQoL. 5 Overall, the prevalence of psoriasis has been estimated to be about 2% of the population, 6 – 8 although this figure may vary markedly between geographic regions and ethnic groups. A recent, population-based survey of more than 20,000 adults in France revealed a psoriasis prevalence of 4.42%.…”

“…Besides its deleterious effect on HRQoL, psoriasis presents specific, major burdens to patients such as troublesome itch, which is a significant symptom in many patients. 3 In addition, society and health care payors are affected due to the large socioeconomic burden of psoriasis: this includes loss of work productivity 8 , 10 – 12 and treatment costs. In particular, treatment costs for biologic agents including biosimilars are significantly higher than those with topical therapies.…”

Cost-utility of secukinumab in Italian patients with moderate to severe plaque-type psoriasis

“…These were counterbalanced by a decrease of €637, with reference to the cost of medical visits and laboratory tests (€291 vs €928), without accounting for non-medical direct costs. The studies calculated a total decrease in spending derived from the usage of biologic drugs of about €1,000/year (€701 vs €1,752) (9,38). Considering also the societal perspective, data demonstrated even greater reduction when accounting for indirect costs (related to reduced productivity at work or in working days lost), for an average saving of around €2,800/year (€1,133 vs €3,960) (9).…”