Out-of-pocket costs for patients with psoriasis in an outpatient dermatology referral service

Abstract

Background Psoriasis is a chronic disease that derives great costs to the health care system. In Colombia, due to deficiencies in this system, patients are more likely to incur in out-of-pocket expenses; money that has never been quantified in this country. Objectives To quantify out-of-pocket expenses and to analyze their relation to patients' clinical and labor characteristics in a cohort of psoriatic patients. Methods A single-center, cross-sectional study was performed, evaluating psoriasis patients. Results A total of 100 psoriasis patients were analyzed. We identified that patients with higher dermatology life quality index and in phototherapy treatment were the ones that had higher out-of-pocket costs (p = 0.006 and 0.005, respectively). We found no correlation between out-of-pocket costs and occupational status, psoriasis area severity index or other types of treatment. The largest amount of money was used to buy medications and bus transportation with a maximum up to 440.50 and 528.60 USD, respectively. Among the 100 participants the total expense was 11131.90 USD in a 6-month period. Study limitations Lack of measurement of the labor productivity and labor absenteeism secondary to sick leave. Conclusion Out-of-pocket costs are similar with what was shown in previous studies. We found statistically significant differences for the DLQI in comparison with out-of-pocket expenses, regardless of the PASI level. Phototherapy treatment also had statistically significant differences in relationship with out-of-pocket expenses, when compared to other treatments, because it requires higher expenses in transportation, copayments, and alimentation during appointment assistance.

Out-of-pocket and catastrophic health expenditure among patients of sexually transmitted infections at a tertiary care center: A cross-sectional study

“…This methodology for OOP expense estimation (direct and indirect costs) is based on that adopted in previous studies. [ 5 6 9 10 ]…”

“…Health-related out-of-pocket expenses comprise expenditures on medical appointments, medications, investigations, food, travel, co-payments, or any other service not covered under the health-care system and to be paid by the patient or family. [ 5 ] Such health-care expenditures that adversely impact the household, forcing them to reduce their necessary expenses as a coping mechanism, are referred to as “catastrophic health expenditures (CHE).”[ 6 ] When the ratio of household’s OOP expenses to total income or capacity to pay achieves a certain threshold value, CHE is said to occur. [ 7 ] The cutoff ratio ranges from 5% to 40% and varies depending on the approaches used.…”

The Skin and Natural Cannabinoids–Topical and Transdermal Applications

“…AD involves a type 2 cytokine inflammatory response with the activation of IL-4 and IL-13 [ 57 , 110 ]. Actual treatments for AD are topical moisturizers, corticosteroids, calcineurin inhibitor, phototherapy, and systemic immunotherapy [ 113 , 114 , 115 , 116 , 117 , 118 , 120 ]. All of these treatments have limited short-term efficacy, significant or even limiting side effects when administered for long periods of time, or are prohibitively expensive [ 113 , 114 , 115 , 116 , 117 , 118 , 120 ].…”