Economic Burden of Comorbidities in Patients with Psoriasis in the USA

Dermatol Ther (Heidelb). 2023 Jan;13(1):207-219. doi: 10.1007/s13555-022-00832-9. Epub 2022 Nov 19.

Abstract

Introduction: This study assessed the comorbidity burden, healthcare resource utilization (HCRU), and costs associated with patients with moderate to severe psoriasis (PsO) compared with a matched cohort of the general population without PsO in the USA.

Methods: Comorbidity-related HCRU (incidence rate ratios [IRRs]) and direct medical cost burden (per patient per month [PPPM] 2020 USD) in patients with moderate to severe PsO in the USA, previously apremilast- and biologic-naive, but currently treated, versus the general population were assessed through a retrospective cohort study using IBM (now Merative) MarketScan Commercial and Medicare Claims data (1 January 2006 to 31 December 2019). Comorbidities included cardiovascular, mental health, pulmonary, diabetes, hyperlipidemia, hypertension, peripheral vascular, liver, obesity, and other autoimmune disorders.

Results: There are increased all-cause HCRU and costs in patients with PsO compared with the general population. These differences (PsO-general population) in HCRU and costs (IRR visits; PPPM) are associated with specific comorbidities, including mental health (1.08; $372), chronic pulmonary disease (1.07; $135), diabetes (1.10; $159), hyperlipidemia (1.13; $203), hypertension (1.13; $305), liver disease (1.21; $360), and obesity (1.12; $145, all P < 0.01).

Conclusions: Patients with PsO experience a higher economic burden of comorbidities than the general population despite using currently available systemic treatments for PsO.

Keywords: Biologics; Claims data; Cohort; Cost; Healthcare resource utilization.

Plain language summary

Psoriasis is a disease that causes itchy and painful sores on the skin. People with psoriasis can develop several other diseases, known as comorbidities. These comorbidities include cardiovascular disease, depression, diabetes, hypertension, and obesity, and they pose a large economic burden to individuals, households, and society. Existing estimates of this burden are outdated because new treatments have become available for psoriasis. The aim of this study was to assess the economic burden of comorbidities in people with psoriasis compared with the economic burden in the general population in the USA. Healthcare claims reported in the IBM (now Merative) MarketScan Commercial and Medicare Claims database were used. This study assessed the total number of health-related visits to a doctor’s office, hospital, or emergency department and the total costs of these visits in both groups. This study found that people with psoriasis had more health visits and costs because of comorbidities than the general population, despite using advanced treatments for their psoriasis.