Die Psoriasis-Krankheitskosten korrelieren mit der Schwere des klinischen Befundes und nicht mit der psychischen Krankheitslast
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- Nelles, S., Daniel, D., Stratmann, L. et al. Pharmacoeconomics-Ger-Res-Articles (2007) 5: 3. doi:10.1007/BF03321569
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The cost of psoriasis correlates with the severity of the disease, not with the psychological burden
Psoriasis is a chronic relapsing immune-mediated illness with a prevalence of 2% in Europe. Nearly 20% of the patients suffer from psoriasis at moderate to severe stage which needs a combined therapy of phototherapy and/or systemic therapy in addition to local therapeutics. Due to the incidence of severe forms, an elevated co-morbidity and the low age of manifestation the application of expensive and high-risk therapies are justified. Therefore, investigations for resource allocation to reach an optimal patient management become more and more important.
The cost of patients suffering from a moderate to severe psoriasis in Germany have been investigated by a multicentre, retrospective health services research study over a period of twelve months viewed from the society’s perspective. Cost data from 92 patients were assessed. The severity of disease has been recorded by using psychologic instruments (Dermatology Life Quality Index, DLQI; EuroQoL, EQ-5D) as well as via a physiologic scale (Psoriasis Area and Severity Index, PASI). A descriptive analysis has been performed. The coefficient of correlation has been calculated by using the Pearson correlation coefficient and the analysis of regression by using the multivariate linear regression.
Patients with moderate to severe psoriasis (PASI > 10) without joint involvement or contraindication to systemic therapy were documented.
All costs were calculated using the valid prices at the time of analysis (July 2005). The therapy caused direct annual costs of €1,495 per patient; third party payers pay €1,377 of this sum and the patient’s co-payment amounts to €118. Indirect costs, amounting to €123 per patient, were caused by travel expenses and inability to work. The average from the DLQI results amounted to 11.2 from a maximum score of 30 (lowest quality of life). The average EQ-5D achieved an index value of 80.1 from a maximum score of 100 (highest possible quality of life). The average PASI delivered a result of 20.8 from 72. A correlation between severity of psoriasis and costs of disease has been found for the physiologic scale, but not for quality of life. Although the study focused on patients suffering from moderate to severe psoriasis requiring combined therapy, 18.5% were treated only locally, which shows a shortcoming of health services.