Objectives: To appraise the literature referred to direct and indirect costs of psoriasis in Europe. Methods: A systematic review of the literature was performed. Electronic databases [MedLine/PubMed, Scopus, Cochrane Library, ISI Wok, MEDES, IBECS, CSIC] and Google Scholar were searched to identify publications referred to direct and indirect costs of psoriasis in Europe. Bibliographic references were hand searched. European studies published in English or Spanish until October 2013 were selected. Economic evaluations of specific drugs and of preventive or diagnostic interventions were excluded. Costs were updated to € , 2013. Results: 12 studies were reviewed (4 German, 2 Swedish, 2 Italian, 1 Dutch, 1 French, 1 English and 1 Spanish). From the social perspective, the mean annual cost of psoriasis in Europe was heterogeneous and varied between € 1,340.25 (Spain) and € 8,253.74 (Italy), mainly due to differences of study sample characteristics, methodology used and national health system features. The highest proportion (68%-82.5%) of total costs was attributable to direct costs (hospitalizations, medications and laboratory tests). The annual total cost of severe psoriasis was, at least, 2.5 fold superior to the costs of mild disease, mostly because of a more frequent use of hospital resources and loss of productivity. Out-of-pocket expenditure ranged from € 480.67 to € 797.00, being mostly explained by the use of dermatological products (OTC) (29%-59.7%) and alternative therapies (balnerotherapies) (24%-49%). The initiation of biologic therapies implied reductions of up to 76% on the length of hospital stay and up to 98% hospital admissions, contributing to a decline of inpatient cost [€ 2,357.30 (SD: 722.29) vs. € 564.19 (SD: 257.62); p= 0.005; UK]. Conclusions: Costs results vary across European countries. Severe psoriasis is a costly disease. The use of biologic agents may contribute to a more efficient management of severe psoriasis due to a more steady control of symptoms that improve clinical outcomes and decrease the needs for hospital care and inpatient cost.
Obradors, M., Figueras, M., Paz, S., Comellas, M., & Lizán, L. (2014). Costs of Psoriasis in Europe. A Systematic Review of the Literature. Value in Health, 17(7), A606. https://doi.org/10.1016/j.jval.2014.08.2112