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The Burden of Moderate to Severe Psoriasis

An Overview

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Abstract

Psoriasis is a chronic, immune-mediated skin disorder that affects 1–3% of the general population worldwide. While considered a non-life-threatening disease, psoriasis represents a social and financial burden for patients and the healthcare system. Individuals suffer from disfigurement and from social stigmatization. Because the disease is usually persistent, patients with a diagnosis of psoriasis usually need lifelong care, which also means a lifetime of expenses. We aimed to conduct a comprehensive review of the evidence available concerning the social burden and costs of psoriasis.

A search for the keywords ‘quality of life’ (QOL) or ‘burden’ or ‘stigmatization’ or ‘psychological factors’ in PubMed up to January 2010 yielded a total of 817 studies. QOL was affected by psoriasis to a degree comparable with diabetes or cancer. A search for ‘cost-of-illness analyses’, in the same period, yielded only seven papers satisfying entry criteria. All the studies but one were performed before biologics became available for psoriasis treatment. Direct costs were higher than indirect costs, with hospitalization representing the most significant item. Treatment costs showed wide variations between different studies. Reasons for these discrepancies are manifold including differences in the selection of the sample, as well as in the methods for calculating costs. There is a need to harmonize methodologies. For a final conclusive judgement of the cost effectiveness of innovative therapies such as biological agents, long-term economic consequences have to be evaluated and long-term remission rates and complications considered.

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Acknowledgements

Conflicts of interest: No sources of funding were used to prepare this article. The authors have no conflicts of interest that are directly relevant to the content of this article and the opinions expressed are those of the authors.

Author contributions: Dr Naldi had full access to all study data and takes responsibility for data integrity and analysis accuracy.

Study concept and design: Naldi, Garattini

Data search and acquisition: Raho, Koleva

Critical appraisal of data: Raho, Koleva, Naldi

Drafting of the manuscript: Raho, Koleva, Naldi

Critical revision of the manuscript content: Naldi, Garattini.

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Authors and Affiliations

  1. Fondazione per la Ricerca Ospedale Maggiore, Presidio Ospedaliero Matteo Rota, Centro Studi Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED), Via Garibaldi 13/15, 24100, Bergamo, Italy

    Giovanna Raho,  Livio Garattini MD & Luigi Naldi

  2. Centro di Economia Sanitaria ‘Angelo e Angela Valenti’ (CESAV), Istituto Mario Negri, Bergamo, Italy

    Daniela Mihajlova Koleva &  Livio Garattini MD

Authors
  1. Giovanna Raho
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  2. Daniela Mihajlova Koleva
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  3. Livio Garattini MD
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  4. Luigi Naldi
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Corresponding author

Correspondence to Livio Garattini MD.

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Raho, G., Mihajlova Koleva, D., Garattini, L. et al. The Burden of Moderate to Severe Psoriasis. PharmacoEconomics 30, 1005–1013 (2012). https://doi.org/10.2165/11591580-000000000-00000

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