Costs and quality of life for psoriatic patients at different degrees of severity in southern Sweden - a cross-sectional study

Objectives: Knowledge of the societal costs of psoriasis is limited. This study estimated the cost of care, psoriasis area and severity index (PASI), and quality of life in a defined patient population in Sweden. Methods: A prevalence-based prospective recruitment of patients visiting two Swedish dermatology clinics between September and December 2009 was performed, collecting resource utilization for health care contacts, treatment, travelling, and productivity loss during 1 month. Results: 164 patients were included. Mean total cost per patient-month was 994(sis). Main cost drivers were outpatient visits and light therapy (49%), biological drugs (20%) and productivity loss (22%). Total cost for topical treatment only (TT; 34%) was 369(sis), light therapy (LT; 24%) 1,274(sis), traditional systemic treatment (TST; 26%) 1,085(sis) and biological systemic treatment (BST; 16%) 1,709(sis) per patient-month. Main cost drivers were: outpatient visits (56%) in TT as well as for LT (78%), productivity loss (40%) in TST, and biological drugs (71%) among BST patients. There was no clear relationship between clinical (PASI) or subjective (DLQI) severity estimations and costs. Conclusions: The one-month cost-of-illness amounted to almost 1,000(sis)/month, with great variations. Despite 1,190(sis) difference in drug cost for TST vs BST, total cost per month differed by 623(sis) because of offsets from improved productivity. A trend towards lower severity and reductions in outpatient and topical treatment costs was seen.