Treatment satisfaction, willingness to pay and quality of life in Japanese patients with psoriasis

Abstract

There is a range of psoriasis treatments available, from topical applications to biologic therapy, with corresponding cost variations. The efficacy of each treatment is usually evaluated by objective measures such as the Psoriasis Area and Severity Index (PASI) or subjective measures such as the Dermatology Life Quality Index (DLQI). However, the social and economic impacts of psoriasis, including cost-effectiveness, have not been assessed in Japan. The EuroQol 5-Dimension (EQ-5D) is a generic instrument used worldwide to calculate quality-adjusted life years, on which calculations of treatment cost-effectiveness are based. We conducted a pilot study to determine the cost-effectiveness of psoriasis treatment in Japan. We administered a questionnaire to 133 patients with psoriasis (105 men and 28 women) who visited four university hospitals in Fukuoka Prefecture. The questionnaire covered medical costs, satisfaction and willingness to pay (WTP), and we investigated the relationships between these items. PASI was evaluated by physicians. More participants indicated satisfaction with treatment in the group paying less than ¥5000/month. WTP, PASI and EQ-5D showed little correlation. However, the DLQI and EQ-5D showed a moderate correlation (r = 0.472). WTP seemed more dependent on participants' economic backgrounds. We found that it was difficult to reflect the PASI with the EQ-5D. However, the DLQI may be used to estimate the cost-benefit relationship in patients with psoriasis. This is the first study to evaluate the EQ-5D in patients with psoriasis in Japan.

The CCL20 and CCR6 axis in psoriasis

“…Males are twice as likely as females to be affected . As desquamative erythema can affect any site of skin, psoriasis profoundly impairs the patients' quality of life, treatment satisfaction and adherence, and socioeconomic stability . Skin injury and environmental factors such as smoking trigger or exacerbate psoriatic lesions .…”

“…3,4 As desquamative erythema can affect any site of skin, psoriasis profoundly impairs the patients' quality of life, treatment satisfaction and adherence, and socioeconomic stability. [5][6][7][8][9] Skin injury and environmental factors such as smoking trigger or exacerbate psoriatic lesions. [10][11][12] The development of psoriasis at sites of traumatized skin is called Koebner phenomenon.…”

Secukinumab rapidly improves EQ-5D health status in patients with psoriasis: Pooled analysis from four phase 3 trials

“…A previous analysis of patients enrolled in the ERASURE and FIXTURE trials evaluated the correlation between greater response in skin clearance and quality of life; a higher proportion of patients with PASI 90-100 than with PASI 75-89 responses at Week 12 achieved a DLQI 0/1 response (69.4% vs. 47.1%; p < .001), which was sustained through Week 52 (74.0% vs. 56.7%; p < .001) (18). However, few studies have examined relationships between skin clearance and improvements in EQ-5D and/or EuroQol-visual analog scale scores, particularly in the United States (19)(20)(21)(22)(23)(24). In the Swedish Psoriasis Registry, marginal changes in PASI were associated with a nonlinear response in EQ-5D-3L (19), and EQ-5D-3L scores correlated weakly with PASI (r ¼ À0.25; p < .001) (20).…”

Autoimmunity and autoimmune co‐morbidities in psoriasis

“…Psoriasis is a chronic, immune‐mediated, inflammatory skin disorder that affects approximately 0·1–3% of the general population worldwide . Given the visible nature of skin lesions, including those on the face, scalp, hands and nails, psoriasis is a significant physical and psychological burden to afflicted patients, decreases patient quality of life, and induces feelings of internalized stigma …”

“…[1][2][3] Given the visible nature of skin lesions, including those on the face, scalp, hands and nails, [4][5][6][7] psoriasis is a significant physical and psychological burden to afflicted patients, decreases patient quality of life, and induces feelings of internalized stigma. [8][9][10][11][12] The disease burden of psoriasis is further increased by its association with psoriatic arthritis, which is characterized by seronegative spondyloarthropathies, enthesitis and elevated C-reactive protein levels. 1,[13][14][15][16] Approximately 15-30% of Caucasians with psoriasis eventually develop psoriatic arthritis.…”