Background: Cost-effectivenessstudiesareimportant for chronic diseases such as psoriasis, which may cause significant financial burden and negatively affect the patient's quality of life. Objectives: This study evaluated which among the treatment options, namely topicals phototherapy (TP), topicals + systemic (TS), and topicals + biologics (TB), is the most cost-effective for the management of moderate to severe psoriasis at the Rizal Medical Center's Psoriasis Center Methods: A total of 65 moderate to severe psoriasis patients seen at the Rizal Medical Center's Psoriasis Center in 2021 were included in this retrospective cross-sectional study. Chart review was conducted to account all direct costs of treatment. The effectiveness in relation to the overall cost was assessed using the psoriasis area severity index (PASI) and the dermatological life quality index (DLQI). Results: Our study showed that TS is the most cost-effective treatment for moderate to severe psoriasis with the lowest cost per PASI75 and DLQI<5 improvement valued at Php335.36, followed by TP valued at Php 762.87, and lastly by TB at Php 19,058.03. Despite TB incurring the highest cost, all patients in this treatment group showed the highest mean difference of PASI and DLQI. Conclusions Our findings suggest that topical with systemic medication is the most cost-effective treatment for moderate to severe psoriasis
Psoriasis ; Cost-Effectiveness Analysis

INTRODUCTION: Costs associated with chronic psoriasis impart a significant economic burden.

OBJECTIVES: This study aims to determine the direct and indirect cost of psoriasis patients in a tertiary government hospital in Davao City.

METHODS: Plaque-type psoriasis patients who were actively seeking care at the Southern Philippines Medical Center Department of Dermatology for at least 6 months prior to the study period were included. The participants reported on socioeconomic status, productivity loss and monetary funding through questionnaires. Work impairment was evaluated using the Work Productivity and Activity Impairment questionnaire and was used to compute the indirect cost. A 6-month retrospective review of the health information system and medical charts generated the healthcare resource utilization data as well as the medical data used to compute the direct cost.

RESULTS: Among the 43 participants enrolled, 53% had a monthly household income of less than PHP8,000 (USD157) and 27% were unemployed. There was an overall work impairment of 65.4%, and 55% had experienced a change in employment status due to psoriasis. The mean 6-month direct cost of psoriasis was PHP22,672.28 ($445). The mean 6-month indirect cost was PHP 26,071.20 ($511) for employment status change and PHP 75,804.30 ($1,486) for work impairment. Government agencies provided financial aid for treatment but majority of the costs came from the participants' own pockets.

CONCLUSION: The economic burden of psoriasis increased substantially due to the indirect cost, which in turn increased remarkably due to work impairment and employment status change.

Economic Burden ; Psoriasis ; Absenteeism ; Presenteeism ; Cost Of Psoriasis

BACKGROUND: The continuous use of biologic agents in the treatment of psoriasis has been reported to result in successful and sustained therapeutic effects and safety. However, some patients choose intermittent and repetitive treatment. OBJECTIVE: To determine the factors for selecting intermittent and repetitive ustekinumab treatment for the management of psoriasis. METHODS: From January 2011 to October 2016, we enrolled 30 psoriasis patients who discontinued ustekinumab treatment and were followed up for psoriasis treatment. We reviewed data regarding patients' clinical characteristics and the treatment they received, and investigated the factors for selecting intermittent treatment. RESULTS: A total of 52 ustekinumab treatment periods were administered to the 30 patients. Of the 52 treatment periods, 34.6% were covered by insurance and 82.4% were discontinued after sufficient improvement had been made or at the patient's request. Further analysis comparing the first and second ustekinumab treatments revealed that the patients who used ustekinumab in second treatment were more likely to be insured. In addition, the rate of patients reaching psoriasis area and severity index (PASI)75 and PASI90 was similar between the first and subsequent ustekinumab treatments. CONCLUSION: We found that the patients who used ustekinumab intermittently were those who were satisfied with the outcome of ustekinumab treatment but could not afford the treatment. These results suggested that economic burden can be a factor for the patients' choice of short-term intermittent treatment. The expansion of insurance coverage can increase the effectiveness of, and patients' satisfaction with, the management of psoriasis.
Biological Factors ; Cost of Illness ; Drug Administration Schedule ; Humans ; Insurance ; Insurance Coverage ; Psoriasis* ; Therapeutic Uses ; Ustekinumab*

BACKGROUND: Drug survival, defined as the time until discontinuation, is a parameter reflecting real-world therapeutic effectiveness. Few studies have examined the influence of economic factors on the drug survival of biologic agents for psoriasis, particularly in Asian countries. OBJECTIVE: To determine the drug survival for ustekinumab in real-life settings and investigate the factors affecting drug survival for psoriasis patients in Korea. METHODS: We evaluated 98 psoriasis patients who were treated with ustekinumab at a single center. We analyzed the efficacy and drug survival of ustekinumab. Cox proportional hazard analysis and competing risk regression analysis were performed to reveal the factors affecting the drug survival of ustekinumab. RESULTS: The overall mean drug survival was 1,596 days (95% confidence interval [CI], 904~2,288). Among the 39 cessations of ustekinumab treatment, 9 (23.1%) patients discontinued treatment after experiencing satisfactory results. Multivariate Cox proportional hazard analysis revealed that paying on patients' own expense was the major predictor for the discontinuation of ustekinumab (hazard ratio [HR], 9.696; 95% CI, 4.088~22.998). Competing risk regression analysis modeling of discontinuation because of factors other than satisfaction of an event also revealed that ustekinumab treatment at the patient's expense (HR, 4.138; 95% CI, 1.684~10.168) was a predictor of discontinuation rather than satisfaction. CONCLUSION: The results of our study revealed that the cost of biologics treatment affects the drug survival of ustekinumab and suggested that economic factors affect the drug survival of ustekinumab treatment in Korea.
Asian Continental Ancestry Group ; Biological Factors ; Biological Products ; Costs and Cost Analysis ; Humans ; Korea* ; Psoriasis* ; Ustekinumab*