Economic and Comorbidity Burden Among Moderate‐to‐Severe Psoriasis Patients with Comorbid Psoriatic Arthritis

Abstract

ObjectiveTo compare the prevalence of comorbidities, health care utilization, and costs between moderate‐to‐severe psoriasis (PsO) patients with comorbid psoriatic arthritis (PsA) and matched controls.MethodsAdults ages 18–64 years with concomitant diagnoses of PsO and PsA (PsO+PsA) were identified in the OptumHealth Reporting and Insights claims database between January 2007 and March 2012. Moderate‐to‐severe PsO was defined based on the use of at least one systemic or phototherapy during the 12‐month study period after the index date (randomly selected date after the first PsO diagnosis). Control patients without PsO and PsA were demographically matched 1:1 with PsO+PsA patients. Multivariate regressions were employed to examine PsO/PsA‐related comorbidities, medications, health care utilization, and costs between PsO+PsA patients and controls, adjusting for demographics, index year, insurance type, and non–PsO/PsA‐related comorbidities.ResultsAmong 1,230 matched pairs of PsO+PsA patients and controls, PsO+PsA patients had significantly more PsO/PsA‐related comorbidities, with the top 3 most common in both groups being hypertension (35.8% versus 23.5%), hyperlipidemia (34.6% versus 28.5%), and diabetes mellitus (15.9% versus 10.0%). Compared with controls, PsO+PsA patients had a higher number of distinct prescriptions filled (incidence rate ratio 2.3, P < 0.05); were more likely to have inpatient admissions (odds ratio [OR] 1.6), emergency room visits (OR 1.3), and outpatient visits (OR 62.7) (all P < 0.05); and incurred significantly higher total, pharmacy, and medical costs (adjusted annual cost differences per patient $23,160, $17,696, and $5,077, respectively; all P < 0.01).ConclusionCompared with matched PsO‐ and PsA‐free controls, moderate‐to‐severe PsO patients with comorbid PsA had higher comorbidity and health care utilization and costs.

The Effects of a Self-Care Program on Promoting Self-Care Behaviors in Patients with Psoriasis

“…The total direct costs associated with psoriasis were estimated at 5 million dollars in the United States in 2006 (13); therefore, the cost of relapse and recurrence can be reduced from 7706 to 25 Euros by implementing nonpharmacological methods (8). Patient education is one of the best nonpharmacological methods and one of the most important roles of nurses (30).…”

“…Psoriasis accounts for 37% and 42% of skin irritations and pain complaints, respectively (12). Depression is also a common disorder in these patients (13). In a study by Ghorbani et al in 2012 on 854 patients with psoriasis, referred to Imam Khomeini Hospital from 2006 to 2011, it was revealed that 36% of the patients had more than 1 psoriasis-related disorder.…”

“Adherence” and “compliance” in the treatment of psoriasis – literature review

“…koszty terapii W przeprowadzonym niedawno badaniu na temat obciążenia ekonomicznego i chorób współistnie-jących u pacjentów z łuszczycą w porównaniu z grupą kontrolną stwierdzono, że u chorych na łuszczycę częściej występuje nadciśnienie tętnicze, cukrzyca typu 2, otyłość, zespół metaboliczny lub choroba niedokrwienna serca, co wiąże się często z koniecznością wczesnego włączenia kilku leków oraz zwięk-szeniem kosztów terapii i zmniejsza stopień przestrzegania zaleceń terapeutycznych. W porównaniu z grupą kontrolną pacjentom chorym na łuszczycę przepisywano na receptach większą liczbę różnych leków, częściej byli oni przyjmowani do szpitala, częściej korzystali z opieki doraźnej i ambulatoryjnej oraz ponosili znacząco większe koszty zakupu leków i inne koszty medyczne [35].…”

Clinical and anamnestic criteria of the progression of psoriasis

“…Такой широкий диапазон показателей рас-пространенности ПсА вероятнее всего объясняется расовыми различиями, генетическим фоном, кли-матогеографическими особенностями, а также ва-риабельностью клинической картины в дебюте за-болевания, отсутствием единых критериев диагно-стики и дифференциальной диагностики ПсА. В результате исследователи при составлении стати-стических сводок в группу ПсА относят разные кли-нико-анатомические проявления псориатической артропатии, такие как артралгия, воспалительные (артриты) и дистрофические процессы суставов (ар-трозы) [24].…”

“…По мнению ря-да авторов, в 60-75% случаев суставной синдром наблюдается у больных с длительно существующим псориатическим процессом, реже суставные изме-нения предшествуют кожным (15%) или возникают одновременно с ними (10%) [10,53]. Есть данные о синхронном ухудшении клинического течения кож-ного и суставного синдромов [54].…”